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Where technology does not go: specialised neonatal care in resource-poor and conflict-affected contexts | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Where technology does not go: specialised neonatal care in resource-poor and conflict-affected contexts

Dornemann J, van den Boogaard W, Van der Bergh R, Takarinda KC, Martinez P, Bekouanebandi JG, Javed I, Ndelema B, Lefevre A, Khalid GG, Zuniga I
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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.

Countries

Afghanistan Burundi Central African Republic Democratic Republic of Congo Niger Pakistan Sierra Leone

Subject Area

pediatricsneonatal health

Languages

English
DOI
10.5588/pha.16.0127
Published Date
21 Jun 2017
PubMed ID
28695092
Journal
Public Health Action
Volume | Issue | Pages
Volume 7, Issue 2, Pages 168-174
Issue Date
2017-06-21
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