MEBCI 2.0

Making Every Baby Count Initiative 2.0

Responding to stagnating neonatal mortality rates in Ghana, the original Making Every Baby Count Initiative (MEBCI) was a five-year collaborative project between the Ghana Health Service (GHS), PATH, and Kybele funded by the Children’s Investment Fund Foundation (CIFF) undertaken to improve the quality of newborn care provided around the time of birth. A multi-pronged approach was used to build health worker capacity in resuscitation, essential newborn care, and infection prevention using a curriculum built on the American Academy of Pediatric’s (AAP) Helping Babies Breathe and Essential Care for Every Baby modules with an added section on infection prevention. MEBCI used a training of trainer’s approach to train 3,688 health workers from district-level facilities in four regions in Ghana between 2015-17.

The original MEBCI investment reached 90% coverage in basic newborn care training across Ghana but stopped short of providing training to health workers in advanced newborn care/ treatment of sick babies. CIFF invited Kybele to lead MEBCI 2.0 from 2020-2024 to address the gaps identified in the secondary and tertiary level hospitals for treatment of sick babies as highlighted in original MEBCI external evaluation and in line with global norms (trained staff, standardized clinical protocols, essential medicines, medical equipment and supplies, appropriate processes preventing delays in care, emergency response, and referrals).

The goal of MEBCI 2.0 was for 90% of babies born in targeted health facilities to receive essential newborn care and interventions to address asphyxia, infection, and prematurity according to the government guidelines. Targeted high-volume referral hospitals include Greater Accra Regional Hospital, Tema General Hospital, Koforidua Regional Hospital, and Sunyani Regional Hospital as well as up to 20 district level hospitals that most commonly refer patients for secondary or tertiary level care.

Specifically, the initiative builds the capacity of frontline staff to provide advanced-level newborn clinical care, supports ongoing quality improvement, provides essential equipment and supplies, establishes hospital data systems data systems that can measure clinical and operational processes and impact linked to a mechanism for accountability for results, brings operational protocols in line with global standards and best practices, and strengthens referral within and between hospitals. Ultimately, MEBCI 2.0 aims to reduce institutional perinatal mortality by 15% in four high-volume regional referral facilities and provide a template for scale-up of advanced newborn care in Ghana.

Tremendous progress has been made across the project objectives.

As of mid-2024, MEBCI has:

  • Created and deployed 10 clinical and operational modules;
  • Trained 2,867 participants engaging 89% of targeted clinicians across the four hospitals;
  • Demonstrated an average knowledge gain of 21% (weighted averages: pre-test 63% verses post-test 84%);
  • Supported 61 quality improvement projects that are initiated and led by facilities based on identified gaps.

 

Additionally, MEBCI 2.0 has:

  • Deployed 982 pieces of major equipment (e.g. CPAP) and 1,392 pieces of minor equipment (e.g. Dopplers);
  • Conducted training on the use of equipment among clinicians and biomedical technicians.

 

To ensure high quality data is tracked and used to improve care, MEBCI 2.0 in coordination with GHS spearheaded the development of 15 advanced clinical care forms for integration into the national electronic medical record system and developed a dashboard for use by facilities. Finally, advocacy among healthcare leadership for adoption of newborn care standards has been central to MEBCI’s efforts leading to the development of the first national guidelines on advanced newborn care which have received final approval by the GHS.