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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Neonatal care in developing countries
1International Maternal Health, Institute of Child Health, University College London Medical School.
Insights
Many newborn deaths globally could be prevented with basic, low-cost newborn care interventions. Improved care and simple technologies can significantly reduce early neonatal mortality and morbidity in developing countries.
Area of Science:
- Neonatal Health
- Global Public Health
- Pediatrics
Background:
- Neonatal mortality remains a significant global health challenge, with approximately eight newborn deaths occurring each minute worldwide.
- Interventions for early neonatal mortality and morbidity are often under-prioritized in developing nations.
- A misconception exists that neonatal care is prohibitively expensive for widespread implementation in resource-limited settings.
Purpose of the Study:
- To highlight the feasibility and effectiveness of low-cost interventions for reducing neonatal mortality.
- To advocate for increased prioritization of basic newborn care in developing countries.
- To demonstrate that many neonatal deaths can be prevented or managed with accessible and affordable methods.
Main Methods:
- Review of established principles of basic newborn care, including atraumatic/clean delivery, thermal maintenance, respiratory support, and early breastfeeding.
- Assessment of the role of healthcare providers (nurse midwives) and community health workers (traditional birth attendants, family members) in facilitating basic care.
- Evaluation of the potential for low-cost, simple technologies in district hospitals to manage sick, preterm, or low birth weight neonates (10%-15% of births).
Main Results:
- Basic newborn care principles, when implemented effectively, can prevent many neonatal deaths.
- Improved care and the application of low-technology interventions are cost-effective strategies for reducing neonatal mortality and morbidity.
- Specialized, low-cost care can be provided at district hospitals for vulnerable newborns.
Conclusions:
- Effective neonatal care does not require high-cost technology and can be achieved through improved practices and accessible interventions.
- Prioritizing basic newborn care, including clean delivery, temperature maintenance, respiratory support, and breastfeeding, is crucial for reducing global neonatal mortality.
- Simple, appropriate technologies at the district hospital level can manage higher-risk newborns, complementing basic care efforts.
Abstract:
Worldwide, about eight newborn babies die every minute, yet interventions to reduce early neonatal mortality and morbidity are still not given high priority in most developing countries. It is often assumed that neonatal care is too costly for high coverage in poor populations, but in fact many deaths could be prevented or treated with low technology and improved care. There are four principles of basic newborn care: an atraumatic and clean delivery, maintenance of body temperature, initiation of spontaneous respiration and breast feeding shortly after birth. For the majority these could be facilitated at the health centre by nurse midwives or at home by TBAs or family members. Low cost special care for many of the 10%-15% who are sick or pre-term or low birth weight could be provided at district hospitals using appropriate simple technologies.
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