Measuring coverage in MNCH: indicators for global tracking of newborn care.

Neonatal mortality accounts for 43% of under-five mortality. Consequently, improving newborn survival is a global priority. However, although there is increasing consensus on the packages and specific interventions that need to be scaled up to reduce neonatal mortality, there is a lack of clarity on the indicators needed to measure progress. In 2008, in an effort to improve newborn survival, the Newborn Indicators Technical Working Group (TWG) was convened by the Saving Newborn Lives program at Save the Children to provide a forum to develop the indicators and standard measurement tools that are needed to measure coverage of key newborn interventions. The TWG, which included evaluation and measurement experts, researchers, individuals from United Nations agencies and non-governmental organizations, and donors, prioritized improved consistency of measurement of postnatal care for women and newborns and of immediate care behaviors and practices for newborns. In addition, the TWG promoted increased data availability through inclusion of additional questions in nationally representative surveys, such as the United States Agency for International Development-supported Demographic and Health Surveys and the United Nations Children's Fund-supported Multiple Indicator Cluster Surveys. Several studies have been undertaken that have informed revisions of indicators and survey tools, and global postnatal care coverage indicators have been finalized. Consensus has been achieved on three additional indicators for care of the newborn after birth (drying, delayed bathing, and cutting the cord with a clean instrument), and on testing two further indicators (immediate skin-to-skin care and applications to the umbilical cord). Finally, important measurement gaps have been identified regarding coverage data for evidence-based interventions, such as Kangaroo Mother Care and care seeking for newborn infection

Proportion of women who received postnatal care within two days of delivery by time of first visit, DHS survey data 2005–2011 [<b>18</b>].

<p>Proportion of women who received postnatal care within two days of delivery by time of first visit, DHS survey data 2005–2011 <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001415#pmed.1001415-MEASURE1" target="_blank">[<b>18</b>]</a>.</p

Postnatal care indicator: measurement issues and advances.

<p>Postnatal care indicator: measurement issues and advances.</p

Standard questionnaire for measuring coverage of immediate newborn care.

<p>Standard questionnaire for measuring coverage of immediate newborn care.</p

Proportion of home births for which women and babies received postnatal care within two days of delivery, DHS survey data 2005–2011 [<b>18</b>].

<p>Proportion of home births for which women and babies received postnatal care within two days of delivery, DHS survey data 2005–2011 <a href="http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001415#pmed.1001415-MEASURE1" target="_blank">[<b>18</b>]</a>.</p

Recommended indicators for care behaviors and practices for newborns.

<p>Surveys will vary in period of recall. Typically, DHS surveys use a recall period of five years, while MICS surveys use a two-year period. Interviewer records all substances put on the cord from cutting until it falls off. Harmful substances are determined locally and split out during analysis.</p

Monitoring pollution in river Mure , Romania, Part III: biochemical effect markers in fish and integrative reflection

Along a downstream stretch of River Mure , Romania, adult males of two feral fish species, European chub (Leuciscus cephalus) and sneep (Chondrostoma nasus) were sampled at four sites with different levels of contamination. Fish were analysed for the biochemical markers hsp70 (in liver and gills) and hepatic EROD activity, as well as several biometrical parameters (age, length, wet weight, condition factor). None of the biochemical markers correlated with any biometrical parameter, thus biomarker reactions were related to site-specific criteria. While the hepatic hsp70 level did not differ among the sites, significant elevation of the hsp70 level in the gills revealed proteotoxic damage in chub at the most upstream site, where we recorded the highest heavy metal contamination of the investigated stretch, and in both chub and sneep at the site right downstream of the city of Arad. In both species, significantly elevated hepatic EROD activity downstream of Arad indicated that fish from these sites are also exposed to organic chemicals. The results were indicative of impaired fish health at least at three of the four investigated sites. The approach to relate biomarker responses to analytical data on pollution was shown to fit well the recent EU demands on further enhanced efforts in the monitoring of Romanian water quality