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Regionalized perinatal care in developing countries.

Vinod K Paul1, Meharban Singh

  • 1Department of Paediatrics, WHO Collaborating Centre for Training and Research in Newborn Care, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. vinodpaul@neonatalhealth.com

Seminars in Neonatology : SN
|November 1, 2005
PubMed
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Developing countries face high rates of newborn mortality, primarily among full-term infants. Simple, community-based newborn care and midwife-led facility care can significantly reduce these deaths.

Area of Science:

  • Global Health
  • Perinatal Medicine
  • Neonatology

Background:

  • Neonatal-perinatal mortality disproportionately affects developing nations, accounting for most global births, fetal deaths, and neonatal deaths.
  • Developed countries implemented regionalized perinatal services for very-low-birthweight infants, a model not always suitable for developing countries.
  • Developing countries experience significant newborn morbidity and mortality among full-term and moderate low-birthweight neonates, often manageable at community or basic hospital levels.

Purpose of the Study:

  • To evaluate the relevance and affordability of developed country perinatal care models in developing nations.
  • To identify effective strategies for reducing neonatal mortality in resource-poor settings.
  • To advocate for community-based and midwife-led perinatal care approaches.

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Main Methods:

  • Analysis of global and regional data on neonatal-perinatal ill health and mortality.
  • Comparison of healthcare models in developed versus developing countries.
  • Assessment of the applicability of home-based and simple facility-based newborn care.

Main Results:

  • The majority of global births and neonatal deaths occur in less developed countries.
  • A substantial portion of newborn mortality in developing countries involves infants who do not require highly specialized intensive care.
  • The regionalized perinatal care model from developed countries is often unaffordable and irrelevant for developing nations.

Conclusions:

  • Home-based newborn care by community health workers is a viable strategy for resource-poor settings.
  • Promoting institutional perinatal care at simple facilities staffed by trained midwives can lower neonatal mortality rates.
  • Adapted, affordable, and accessible perinatal care models are crucial for reducing newborn mortality in developing countries.