Rolling out chlorhexidine for umbilical cord care in Bangladesh and beyond

Globally, newborn sepsis is the cause of over 500,000 of the 3.1 million newborn deaths each year. Applying a 4% chlorhexidine product (7.1% chlorhexidine digluconate) to the umbilical cord saves newborn lives and is a cost-effective intervention. Data from Bangladesh, Nepal, and Pakistan demonstrated an aggregate 23% reduction in neonatal mortality (not including deaths in the first few hours of life) and a 68% reduction in severe infections for the chlorhexidine intervention groups. In Bangladesh the neonatal mortality rate, representing death in the first month of life, remains high at 37 deaths per 1,000 live births, and neonatal sepsis causes almost 30,000 newborn deaths annually. We propose to develop replicable, sustainable, chlorhexidine product introduction approaches in Bangladesh in order to contribute to the reduction of neonatal mortality. Bangladesh has numerous nongovernmental organizations and a thriving pharmaceutical industry which will be leveraged to accelerate product introduction. Adoption of a chlorhexidine product will be facilitated by gaining endorsements from policymakers and medical professionals, expanding access to and use of the product by appropriate promotion, and by ensuring proper use through training. By the end of the project, we will document lessons learned and identify the most promising introduction and marketing approaches. These will be disseminated to key stakeholders in sub-Saharan Africa - where sepsis causes 5% of newborn deaths - in preparation for possible introduction of a chlorhexidine product in the region.