Guideline for Introduction of 7.1% Chlorhexidine Digluconate for Umbilical Cord Care

The Ministry of Public Health (MOPH) aims to increase awareness and use of this product among policy makers, birth attendants, and families. The strategic goals include establishing a sustainable supply-side strategy, generating increased demand at the country level, advocating for inclusion of chlorhexidine for umbilical cord care in country policies, and increasing awareness and use of the product. Decreasing maternal, newborn, and child health mortality is a major concern for most countries, and efforts are underway to achieve the desired goals through global and in-country initiatives. The Every Newborn Action Plan and the UN Commission on Life-Saving Commodities for Women and Children have identified 7.1% chlorhexidine digluconate as a priority medicine for reducing maternal and neonatal deaths. In Afghanistan, a large proportion of maternal and neonatal deaths occur during the 24 hours following delivery, with 26.4% of neonatal deaths caused by infection. The leading causes of newborn death in Afghanistan include acute respiratory infections and other infections, perinatal related disorders, and preterm/low birthweight. The MOPH has emphasized the need to refocus efforts on reducing newborn mortality, as noted in the "Kabul Declaration for Maternal and Child Health: Renewing Commitment to Reducing Preventable Deaths among Women and Children." The MOPH commits to increasing essential and emergency care of sick newborns to at least 50% by 2020, with a special focus on case management of severe neonatal infection, kangaroo mother care, and neonatal resuscitation. The introduction of 7.1% chlorhexidine digluconate for umbilical cord care is a critical step towards achieving these goals. The product has been selected as a priority medicine by the UN Commission on Life-Saving Commodities for Women and Children, and its use has been shown to reduce neonatal mortality. The MOPH aims to create a positive environment for the introduction of this product by harmonizing and aligning activities with the current health system in Afghanistan. The guideline for the introduction of 7.1% chlorhexidine digluconate for umbilical cord care outlines the actions and factors to consider in expanding access to this product. The guideline aims to create a smooth and effective operationalization of the new product and to establish a sustainable supply-side strategy to support the demand for 7.1% chlorhexidine digluconate. The guideline also emphasizes the need for behavior change communication and information, education, and communication (IEC) material development and campaign to generate increased demand at the country level. The guideline outlines the key steps for the introduction of 7.1% chlorhexidine digluconate for umbilical cord care, including product registration, update of the national essential drug list and national licensed drug list, update of the standard treatment guidelines, delivery through the health system, phasing of introduction, supply planning, training of service providers, quality assurance, monitoring and evaluation, and logistics management information system integration. The guideline also emphasizes the need for a behavior change communication campaign to generate increased demand for the product. The introduction of 7.1% chlorhexidine digluconate for umbilical cord care has the potential to significantly improve neonatal health in Afghanistan. The product has been shown to reduce neonatal mortality, and its introduction is a critical step towards achieving the MOPH's goal of reducing newborn mortality. The guideline for the introduction of 7.1% chlorhexidine digluconate for umbilical cord care provides a framework for the successful introduction of this product and outlines the key steps for its implementation.