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  • Chlorhexidine to Reduce Infant Mortality

Chlorhexidine to Reduce Infant Mortality

[UPDATED OCTOBER 2015]  Chlorhexidine, a low-cost antiseptic, prevents deadly infections that enter an infant’s body through a newly cut umbilical cord. Few other interventions have as much promise to rapidly reduce newborn deaths at an affordable price—less than $1 per dose. Chlorhexidine has no toxicity risks and virtually no potential for misuse. It has a long shelf life, requires no cold chain, and is extremely easy to apply with minimal training and no equipment.

These factors make it suitable for hospital, health center, and home care alike. Few other interventions have demonstrated such potential for rapidly reducing newborn mortality across so many settings for such a low cost.

In July 2013, the World Health Organization included 7.1% chlorhexidine digluconate (delivering 4% chlorhexidine) for umbilical cord care on the WHO Model List of Essential Medicines for Children. In October 2013, WHO issued new guidelines for umbilical cord care that recommend daily application of 7.1% chlorhexidine digluconate to the umbilical cord stump for the first week of life in areas with high neonatal mortality.

Millions of mothers and health providers around the world continue to have a strong desire to apply something to the umbilical cord stump, and putting nothing on the cord stump is simply unacceptable in some cultures or communities. In the absence of a specifically recommended product, they use a variety of traditional and non-traditional substances, including breast milk, cooking and motor oil, dried cow dung, ash, alcohol, traditional herbs, salty water, mustard seed oil, turmeric, antibacterial ointments, and numerous other preparations.

In this installment of "Trending Topics" the Health COMpass presents several communication tools and project examples designed to promote and explain the use of chlorhexidine to reduce newborn mortality.


For further reading about chlorhexidine:


Topical Umbilical Cord Care at Birth [Reproductive Health Library]

Chlorhexidine for Umbilical Cord Care: Selected Bibliography [2014]

Chlorhexidine for umbilical cord care: game-changer for newborn survival? [2013]

Country Guidance for Umbilical Cord Care [WHO, 2014]

Ending Newborn Deaths [Save the Children, 2014]


Above photo: © 2013 Fletcher Gong’a, Courtesy of Photoshare

Resources

  • Tools
  • Examples

Demand Generation for Underutilized Commodities in RMNCH [Implementation Kit]

This Implementation Kit (I-Kit) is a step-by-step guide to developing communication strategies to increase demand for the 13 underutilized commodities identified by the UN Commission on Life-Saving Commodities.

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WHO Recommendations on Postnatal Care of the Mother and Newborn

The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited.
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An Adaptable Communication Strategy for Chlorhexidine

The Adaptable Communication Strategy for Chlorhexidine provides step-by-step guidance and illustrative content in creating a communication strategy to generate demand for chlorhexidine.  It is designed to be useful to multiple audiences, including staff from ministries of health, non-governmental organizations (NGO) and community-based organizat

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Scaling Up Lifesaving Commodities for Women, Children, and Newborns: An Advocacy Toolkit

This toolkit provides information about the UN Commission on Life-Saving Commodities for Women and Children (the Commodities Commission), its 13 priority commodities, and examples of how its ten recommendations to improve access and availability are being applied globally and within countries.

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Chlorhexidine for Umbilical Cord Care

Sub-Saharan Africa

This is a film for health workers and communities providing safe newborn care. The film demonstrates how to effectively use chlorhexidine to provide safe umbilical cord care after birth.

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Chlorhexidine Gel [Poster, Nepal]

Nepal

This poster illustrates how to apply chlorhexidine gel to the umbilical cord after delivery to prevent infection. It explains how to apply the gel and how to care for the cord afterwards.

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Chlorhexidine Instruction Poster [Bangladesh]

Bangladesh

This poster illusrates and describes the proper procedure for application of Chlorhexidrine to the baby's umbilical cord immediately after birth so as to prevent infection.

Download

Five Key Messages of Essential Newborn Care [Poster, Nepal]

Nepal

This poster provides guidelines to service providers regarding five essential steps after childbirth:

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7.1% Chlorhexidine Digluconate w/v Training Manual [Nepal]

Nepal

This is a training curriculum for service providers in Nepal, as they learn about the use of chlorhexidine to reduce neonatal mortality.

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AroFoitra Poster

Madagascar

This poster demonstrates the proper way to use Chlorhexidine digluconate -- a gel for umbilical cord care in newborns.

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Anna Helland
Amrita Gill-Bailey

This website is made possible by the support of the American People through the United States Agency for International Development (USAID) under the Breakthrough-ACTION Project, supported by USAID’s Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-17-00017 with the Johns Hopkins University.

Breakthrough-ACTION is based at the Johns Hopkins Bloomberg School of Public Health’s Center for Communication Programs (JHU∙CCP). The contents of this website are the sole responsibility of JHU∙CCP. The information provided on this website is not official U.S. Government information and does not necessarily represent the views or positions of USAID, the United States Government, or The Johns Hopkins University.

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