Policy Implementation to Practice: For sick newborns with possible serious bacterial infections in Ethiopia

Ethiopia’s Community-Based Newborn Care (CBNC) program seeks to reduce newborn mortality and serve the most vulnerable populations by bringing health services closer to communities. Core elements of CBNC include early identification and timely, appropriate management of young infants with possible serious bacterial infection (PSBI). According to the national CBNC implementation guidelines, all PSBI cases must be referred but can be managed at health post (HP) level when a referral is not accepted and/or possible (Box 1). Appropriate treatment of PSBI cases requires a well-functioning and responsive referral system. The referral pathway for neonates with suspected PSBI includes identification at the household level and care at HP, health centres (HC), and hospital levels (Figure 1). Early experience in implementation of CBNC indicates that 80% of PSBI cases seen at HP are being treated by health extension workers (HEWs) at the HP, and around 20% are being referred to higher facilities.