The Dominica 2010-2019 Strategic Plan for Health includes high perinatal mortality rates as one of the major challenges in Dominica. The Government's objective is to reduce the perinatal mortality rate to 10 per 1000 births by the end of 2019. Current scientific knowledge shows that neonatal deaths and stillbirths stem from poor maternal health, inadequate care during pregnancy, inappropriate management of complications during pregnancy, delivery and the first critical hours after birth, as well as weaknesses in newborn care. Therefore, interventions to reduce perinatal mortality should target the maternal (pregnancy, labour and delivery and post partum) and neonatal periods.
A consultancy mission was therefore initiated and funded by the EU to provide technical support for the designing of an evidence-based, integrated and context specific support framework, supported by a sustainable data collection and information management system.
- Provide recommendations for a sustainable intervention programme to reduce the IMR from 29.9 per 1000 to 10 per 1000 by the end of 2019 in keeping with objectives for reducing infant mortality stated in the National Strategic Plan for Health 2010-2019.
- Develop an Action Plan for implementation of the programme with a time schedule and annual SMART Indicators. Propose two most relevant indicators for the needs of variable tranche under the 10th EDF Multi-sector Budget Support Programme.
- Provide recommendations for implementation of comprehensive perinatal and neonatal databases, and
- Provide recommendations for the resources required for implementation of the Intervention Programme and the Comprehensive Databases.
Coming out of this mission, the variable tranche indicators for the 10th EDF were also finalised and accepted by the EU Delegation, as follows:
- Indicator #1: Review/update of MCH Manual to be in line with WHO/PAHO standards.
- Indicator #2: Number of Neonatal deaths due to sepsis.
The Office of the NAO plays a monitoring role in this intervention as it relates to the implementation of the Action Plan to Reduce Infant Mortality.