Collaboration with non-emergency care specialists and other emergency care providers: A research primer for low- and middle-income countries

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

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COVID-19 preparedness—a survey among neonatal care providers in low- and middle-income countries

Journal of Perinatology ◽

10.1038/s41372-021-01019-4 ◽

2021 ◽

Author(s):

Claus Klingenberg ◽

◽

Sahil K. Tembulkar ◽

Anna Lavizzari ◽

Charles C. Roehr ◽

...

Keyword(s):

Low Income ◽

Care Delivery ◽

Neonatal Care ◽

Sub Saharan Africa ◽

World Health ◽

Care Providers ◽

Clinical Practices ◽

Middle Income ◽

Middle Income Countries ◽

Low And Middle Income

Abstract Objective To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents. Study design Cross-sectional, web-based survey administered between May and June, 2020. Results Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making. Conclusions Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

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The ethical considerations for emergency care research in low- and middle-income countries: A scoping review of the published literature

African Journal of Emergency Medicine ◽

10.1016/j.afjem.2021.12.001 ◽

2022 ◽

Vol 12 (1) ◽

pp. 71-76

Author(s):

Sarah Hirner ◽

Colleen Saunders ◽

Willem Stassen

Keyword(s):

Scoping Review ◽

Emergency Care ◽

Ethical Considerations ◽

Middle Income ◽

Care Research ◽

Middle Income Countries ◽

Low And Middle Income

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Adapting cleft care protocols in low- and middle-income countries during and after COVID-19: a process-driven review with recommendations

10.1101/2021.10.14.21265004 ◽

2021 ◽

Author(s):

Matthew John Fell ◽

Michael Goldwasser ◽

BS Jayanth ◽

Rui Manuel Rodrigues Pereira ◽

Christian Tshisuz Nawej ◽

...

Keyword(s):

Working Group ◽

Cleft Lip ◽

Cleft Lip And Palate ◽

Care Providers ◽

Resource Constrained ◽

Middle Income ◽

Middle Income Countries ◽

International Working Group ◽

Consensus Recommendations ◽

Low And Middle Income

Objective: A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptions to cleft care protocols during and after COVID as a priority learning area of need. Design: A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptions to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organisations involved in comprehensive cleft care. Results: Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinised and COVID adaptions, specifically in the pre and peri-operative periods, were highlighted. Second, surgical operations and access to services were prioritized according to their relationship to functional outcomes and time-sensitivity. The operations assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft services assigned the highest priority were new-born assessments, paediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. Conclusions: A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

Download Full-text