Where Technology Does Not Go: Specialised Neonatal Care in Resource-Poor and Conflict-Affected Contexts

Hdl Handle:
http://hdl.handle.net/10144/618959
Title:
Where Technology Does Not Go: Specialised Neonatal Care in Resource-Poor and Conflict-Affected Contexts
Authors:
Dörnemann, J; van den Boogaard, W; Van den Bergh, R; Takarinda, K; Martinez, P; Bekouanebandi, J; Javed, I; Ndelema, B; Lefèvre, A; Khalid, G; Zuniga, I
Journal:
Public Health Action
Abstract:
Setting: Although neonatal mortality is gradually decreasing worldwide, 98% of neonatal deaths occur in low- and middle-income countries, where hospital care for sick and premature neonates is often unavailable. Médecins Sans Frontières Operational Centre Brussels (MSF-OCB) managed eight specialised neonatal care units (SNCUs) at district level in low-resource and conflict-affected settings in seven countries. Objective: To assess the performance of the MSF SNCU model across different settings in Africa and Southern Asia, and to describe the set-up of eight SNCUs, neonate characteristics and clinical outcomes among neonates from 2012 to 2015. Design: Multicentric descriptive study. Results: The MSF SNCU model was characterised by an absence of high-tech equipment and an emphasis on dedicated nursing and medical care. Focus was on the management of hypothermia, hypoglycaemia, feeding support and early identification/treatment of infection. Overall, 11 970 neonates were admitted, 41% of whom had low birthweight (<2500 g). The main diagnoses were low birthweight, asphyxia and neonatal infections. Overall mortality was 17%, with consistency across the sites. Chances of survival increased with higher birthweight. Conclusion: The standardised SNCU model was implemented across different contexts and showed in-patient outcomes within acceptable limits. Low-tech medical care for sick and premature neonates can and should be implemented at district hospital level in low-resource settings.
Publisher:
International Union Against Tuberculosis and Lung Disease
Issue Date:
21-Jun-2017
URI:
http://hdl.handle.net/10144/618959
DOI:
10.5588/pha.16.0127
PubMed ID:
28695092
Submitted date:
2017-07-18
Language:
en
ISSN:
2220-8372
Appears in Collections:
Paediatrics

Full metadata record

DC FieldValue Language
dc.contributor.authorDörnemann, Jen
dc.contributor.authorvan den Boogaard, Wen
dc.contributor.authorVan den Bergh, Ren
dc.contributor.authorTakarinda, Ken
dc.contributor.authorMartinez, Pen
dc.contributor.authorBekouanebandi, Jen
dc.contributor.authorJaved, Ien
dc.contributor.authorNdelema, Ben
dc.contributor.authorLefèvre, Aen
dc.contributor.authorKhalid, Gen
dc.contributor.authorZuniga, Ien
dc.date.accessioned2017-07-19T13:25:31Z-
dc.date.available2017-07-19T13:25:31Z-
dc.date.issued2017-06-21-
dc.date.submitted2017-07-18-
dc.identifier.citationWhere Technology Does Not Go: Specialised Neonatal Care in Resource-Poor and Conflict-Affected Contexts. 2017, 7 (2):168-174 Public Health Actionen
dc.identifier.issn2220-8372-
dc.identifier.pmid28695092-
dc.identifier.doi10.5588/pha.16.0127-
dc.identifier.urihttp://hdl.handle.net/10144/618959-
dc.description.abstractSetting: Although neonatal mortality is gradually decreasing worldwide, 98% of neonatal deaths occur in low- and middle-income countries, where hospital care for sick and premature neonates is often unavailable. Médecins Sans Frontières Operational Centre Brussels (MSF-OCB) managed eight specialised neonatal care units (SNCUs) at district level in low-resource and conflict-affected settings in seven countries. Objective: To assess the performance of the MSF SNCU model across different settings in Africa and Southern Asia, and to describe the set-up of eight SNCUs, neonate characteristics and clinical outcomes among neonates from 2012 to 2015. Design: Multicentric descriptive study. Results: The MSF SNCU model was characterised by an absence of high-tech equipment and an emphasis on dedicated nursing and medical care. Focus was on the management of hypothermia, hypoglycaemia, feeding support and early identification/treatment of infection. Overall, 11 970 neonates were admitted, 41% of whom had low birthweight (<2500 g). The main diagnoses were low birthweight, asphyxia and neonatal infections. Overall mortality was 17%, with consistency across the sites. Chances of survival increased with higher birthweight. Conclusion: The standardised SNCU model was implemented across different contexts and showed in-patient outcomes within acceptable limits. Low-tech medical care for sick and premature neonates can and should be implemented at district hospital level in low-resource settings.en
dc.language.isoenen
dc.publisherInternational Union Against Tuberculosis and Lung Diseaseen
dc.rightsArchived with thanks to Public Health Actionen
dc.titleWhere Technology Does Not Go: Specialised Neonatal Care in Resource-Poor and Conflict-Affected Contextsen
dc.identifier.journalPublic Health Actionen

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