scholarly journals Helping Babies Breathe Global Development Alliance and the Power of Partnerships

PEDIATRICS ◽  
2020 ◽  
Vol 146 (Supplement_2) ◽  
pp. S145-S154
Author(s):  
William J. Keenan ◽  
Susan Niermeyer ◽  
Anna af Ugglas ◽  
Waldemar A. Carlo ◽  
Robert Clark ◽  
...  
Keyword(s):  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Health System Strengthening ◽  
Dissemination And Implementation ◽  
Global Development ◽  
Essential Newborn Care ◽  
Middle Income ◽  
Helping Babies Breathe ◽  
Middle Income Countries ◽  
Low And Middle Income

The Helping Babies Breathe Global Development Alliance (GDA) was a public–private partnership created simultaneously with the launch of the educational program Helping Babies Breathe to accelerate dissemination and implementation of neonatal resuscitation in low- and middle-income countries with the goal of reducing the global burden of neonatal mortality and morbidity related to birth asphyxia. Representatives from 6 organizations in the GDA highlight the recognized needs that motivated their participation and how they built on one another’s strengths in resuscitation science and education, advocacy, frontline implementation, health system strengthening, and implementation research to achieve common goals. Contributions of time, talent, and financial resources from the community, government, and private corporations and foundations powered an initiative that transformed the landscape for neonatal resuscitation in low- and middle-income countries. The organizations describe the power of partnerships, the challenges they faced, and how each organization was shaped by the collaboration. Although great progress was achieved, lessons learned through the GDA and additional efforts must still be applied to the remaining challenges of prevention, widespread implementation, improvement in the quality of care, and sustainable integration of neonatal resuscitation and essential newborn care into the fabric of health care systems.

scholarly journals Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis

2021 ◽  
Vol 6 (2) ◽  
pp. e003618
Author(s):  
Mirjam Y Kleinhout ◽  
Merel M Stevens ◽  
Kwabena Aqyapong Osman ◽  
Kwame Adu-Bonsaffoh ◽  
Floris Groenendaal ◽  
...  
Keyword(s):  
Low Income ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Evidence Based ◽  
Antenatal Corticosteroids ◽  
Essential Newborn Care ◽  
Middle Income ◽  
Middle Income Countries

BackgroundPreterm birth is the leading cause of under-five-mortality worldwide, with the highest burden in low-income and middle-income countries (LMICs). The aim of this study was to synthesise evidence-based interventions for preterm and low birthweight (LBW) neonates in LMICs, their associated neonatal mortality rate (NMR), and barriers and facilitators to their implementation. This study updates all existing evidence on this topic and reviews evidence on interventions that have not been previously considered in current WHO recommendations.MethodsSix electronic databases were searched until 3 March 2020 for randomised controlled trials reporting NMR of preterm and/or LBW newborns following any intervention in LMICs. Risk ratios for mortality outcomes were pooled where appropriate using a random effects model (PROSPERO registration number: CRD42019139267).Results1236 studies were identified, of which 49 were narratively synthesised and 9 contributed to the meta-analysis. The studies included 39 interventions in 21 countries with 46 993 participants. High-quality evidence suggested significant reduction of NMR following antenatal corticosteroids (Pakistan risk ratio (RR) 0.89; 95% CI 0.80 to 0.99|Guatemala 0.74; 0.68 to 0.81), single cord (0.65; 0.50 to 0.86) and skin cleansing with chlorhexidine (0.72; 0.55 to 0.95), early BCG vaccine (0.64; 0.48 to 0.86; I2 0%), community kangaroo mother care (OR 0.73; 0.55 to 0.97; I2 0%) and home-based newborn care (preterm 0.25; 0.14 to 0.48|LBW 0.42; 0.27 to 0.65). No effects on perinatal (essential newborn care 1.02; 0.91 to 1.14|neonatal resuscitation 0.95; 0.84 to 1.07) or 7-day NMR (essential newborn care 1.03; 0.83 to 1.27|neonatal resuscitation 0.92; 0.77 to 1.09) were observed after training birth attendants.ConclusionThe findings of this study encourage the implementation of additional, evidence-based interventions in the current (WHO) guidelines and to be selective in usage of antenatal corticosteroids, to reduce mortality among preterm and LBW neonates in LMICs. Given the global commitment to end all preventable neonatal deaths by 2030, continuous evaluation and improvement of the current guidelines should be a priority on the agenda.

Intrapartum-related events affecting the newborn

2018 ◽  
pp. 150-154
Author(s):  
Saima Aftab ◽  
Lauren Schaeffer ◽  
Lian Folger ◽  
Anne CC Lee
Keyword(s):  
High Risk ◽  
Secondary Prevention ◽  
Neonatal Resuscitation ◽  
Birth Asphyxia ◽  
Obstetric Care ◽  
Middle Income ◽  
Neonatal Deaths ◽  
Under Five ◽  
Middle Income Countries ◽  
Child Deaths

This chapter addresses the causes, burden, and interventions for intrapartum-related events, or ‘birth asphyxia’. Intrapartum-related neonatal deaths are among the leading causes of under-five child deaths, and account for 26% of all newborn deaths. An estimated one in ten babies will need some help to start breathing at birth. Approximately 98% of intrapartum deaths occur in low- and middle-income countries, as high rates of home births and unattended deliveries remain challenges. High-risk pregnancies should be monitored closely and deliver in facilities with capacity for obstetric and neonatal management. Here we present the evidence for interventions for primary and secondary prevention (including obstetric care, neonatal resuscitation), and tertiary prevention for infants with acute complications.

Understanding the challenges associated with the use of data from routine health information systems in low- and middle-income countries: A systematic review

2020 ◽  
pp. 183335832092872 ◽  
Author(s):  
Klesta Hoxha ◽  
Yuen W Hung ◽  
Bridget R Irwin ◽  
Karen A Grépin
Keyword(s):  
Information Systems ◽  
Health System ◽  
Health Information ◽  
Health Information Systems ◽  
Health System Strengthening ◽  
Middle Income ◽  
Environmental Challenges ◽  
Middle Income Countries ◽  
Data Process ◽  
Low And Middle Income

Background: Routine health information systems (RHISs) are crucial to informing decision-making at all levels of the health system. However, the use of RHIS data in low- and middle-income countries (LMICs) is limited due to concerns regarding quality, accuracy, timeliness, completeness and representativeness. Objective: This study systematically reviewed technical, behavioural and organisational/environmental challenges that hinder the use of RHIS data in LMICs and strategies implemented to overcome these challenges. Method: Four electronic databases were searched for studies describing challenges associated with the use of RHIS data and/or strategies implemented to circumvent these challenges in LMICs. Identified articles were screened against inclusion and exclusion criteria by two independent reviewers. Results: Sixty studies met the inclusion criteria and were included in this review, 55 of which described challenges in using RHIS data and 20 of which focused on strategies to address these challenges. Identified challenges and strategies were organised by their technical, behavioural and organisational/environmental determinants and by the core steps of the data process. Organisational/environmental challenges were the most commonly reported barriers to data use, while technical challenges were the most commonly addressed with strategies. Conclusion: Despite the known benefits of RHIS data for health system strengthening, numerous challenges continue to impede their use in practice. Implications: Additional research is needed to identify effective strategies for addressing the determinants of RHIS use, particularly given the disconnect identified between the type of challenge most commonly described in the literature and the type of challenge most commonly targeted for interventions.

scholarly journals Strengthening mental health systems in low- and middle-income countries: recommendations from the Emerald programme

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Maya Semrau ◽  
Atalay Alem ◽  
Jose L. Ayuso-Mateos ◽  
Dan Chisholm ◽  
Oye Gureje ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Human Resource Development ◽  
Health Systems ◽  
Building Blocks ◽  
Health System Strengthening ◽  
Mental Health Systems ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

BackgroundThere is a large treatment gap for mental, neurological or substance use (MNS) disorders. The ‘Emerging mental health systems in low- and middle-income countries (LMICs)’ (Emerald) research programme attempted to identify strategies to work towards reducing this gap through the strengthening of mental health systems.AimsTo provide a set of proposed recommendations for mental health system strengthening in LMICs.MethodThe Emerald programme was implemented in six LMICs in Africa and Asia (Ethiopia, India, Nepal, Nigeria, South Africa and Uganda) over a 5-year period (2012–2017), and aimed to improve mental health outcomes in the six countries by building capacity and generating evidence to enhance health system strengthening.ResultsThe proposed recommendations align closely with the World Health Organization's key health system strengthening ‘building blocks’ of governance, financing, human resource development, service provision and information systems; knowledge transfer is included as an additional cross-cutting component. Specific recommendations are made in the paper for each of these building blocks based on the body of data that were collected and analysed during Emerald.ConclusionsThese recommendations are relevant not only to the six countries in which their evidential basis was generated, but to other LMICs as well; they may also be generalisable to other non-communicable diseases beyond MNS disorders.Declaration of interestNone.

scholarly journals A Short History of Helping Babies Breathe: Why and How, Then and Now

PEDIATRICS ◽  
2020 ◽  
Vol 146 (Supplement_2) ◽  
pp. S101-S111
Author(s):  
Susan Niermeyer ◽  
George A. Little ◽  
Nalini Singhal ◽  
William J. Keenan
Keyword(s):  
Health Care Providers ◽  
Global Education ◽  
Neonatal Resuscitation ◽  
Dissemination And Implementation ◽  
Care Providers ◽  
Middle Income ◽  
Early Neonatal Mortality ◽  
Helping Babies Breathe ◽  
New Science ◽  
History Of

Helping Babies Breathe (HBB) changed global education in neonatal resuscitation. Although rooted in the technical and educational expertise underpinning the American Academy of Pediatrics’ Neonatal Resuscitation Program, a series of global collaborations and pivotal encounters shaped the program differently. An innovative neonatal simulator, graphic learning materials, and content tailored to address the major causes of neonatal death in low- and middle-income countries empowered providers to take action to help infants in their facilities. Strategic dissemination and implementation through a Global Development Alliance spread the program rapidly, but perhaps the greatest factor in its success was the enthusiasm of participants who experienced the power of being able to improve the outcome of babies. Collaboration continued with frontline users, implementing organizations, researchers, and global health leaders to improve the effectiveness of the program. The second edition of HBB not only incorporated new science but also the accumulated understanding of how to help providers retain and build skills and use quality improvement techniques. Although the implementation of HBB has resulted in significant decreases in fresh stillbirth and early neonatal mortality, the goal of having a skilled and equipped provider at every birth remains to be achieved. Continued collaboration and the leadership of empowered health care providers within their own countries will bring the world closer to this goal.

scholarly journals Ze Lekòl: Contextual Factors Affecting Use of Eggs in School Feeding in Cap-Haïtien, Haiti

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 635-635
Author(s):  
Melissa Chapnick ◽  
Michael Galvin ◽  
Sherlie Jean-Louis ◽  
Henri-Claude Saintelmond ◽  
Emmanuel Gyimah ◽  
...  
Keyword(s):  
Focus Groups ◽  
Egg Production ◽  
Food System ◽  
Dissemination And Implementation ◽  
Preparation Methods ◽  
Middle Income ◽  
Middle Income Countries ◽  
Feeding Programs ◽  
School Feeding ◽  
Low And Middle Income

Abstract Objectives Eggs are a rich source of bioavailable nutrients for children, yet have been underutilized in school feeding programs in low- and middle-income countries. The purpose of the Ze Lekòl Project was to identify contextual facilitators, barriers, and resources needed at both the school and food system levels to link local egg value chains to school feeding programs in Cap-Haïtien, Haiti. Methods Key stakeholder interviews (n = 23) were conducted with school principals, representatives from the Ministry of Health and Ministry of Agriculture, domestic egg producers, and egg vendors. Focus groups (n = 4) were conducted with school staff and child caregivers. Interviews and focus groups were transcribed into Haitian Creole or French, and translated into English. Using inductive and deductive coding, interviews were analyzed for factors that facilitate or hinder the potential for incorporating locally produced eggs in school feeding programs. The approach to data collection and analysis was informed by the EPIS Implementation Science framework. Results School administrators and staff described facilitators (i.e., desire for nutritious foods, acceptability of eggs), barriers (i.e., preparation methods, national school feeding program structure) and potential benefits (i.e., improved student focus, reduced caregiver burden) for including eggs in school feeding programs. Local egg producers and vendors expressed facilitators (bulk purchases, customer preference for domestic eggs) and barriers (local availability of supplies, veterinary care, political disruption) to producing and selling locally produced eggs in Cap-Haïtien. Conclusions Locally produced eggs are an acceptable food to include in school feeding programs in Cap-Haïtien, Haiti. However, lack of sufficient infrastructure for domestic egg production prevents the ability to consistently provide the quantity of eggs needed for such programs without additional investments in domestic agriculture and school feeding programs. Findings from this study will inform interventions aimed at linking local agriculture to school feeding programs in low and middle-income countries. Funding Sources The Washington University in St. Louis Institute for Public Health–Center for Dissemination and Implementation funded this study.

scholarly journals Neonatal Resuscitation Research Priorities in Low- and Middle-Income Countries

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Vivek V. Shukla ◽  
Somashekhar M. Nimbalkar
Keyword(s):  
Research Output ◽  
Neonatal Resuscitation ◽  
Research Priorities ◽  
Evidence Based ◽  
Middle Income ◽  
Liaison Committee ◽  
Middle Income Countries ◽  
Practice Recommendations ◽  
Current Review ◽  
Low And Middle Income

Several critical physiological changes occur during birth. Optimal and timely resuscitation is essential to avoid morbidity and mortality. The International Liaison Committee on Resuscitation (ILCOR) is a multinational committee that publishes evidence-based consensus and treatment recommendations for resuscitation in various scenarios including that for neonatal resuscitation. The majority of perinatal deaths occur in low- and middle-income countries (LMICs); however, there is limited research output from LMICs to generate evidence-based practice recommendations specific for LMICs. The current review identifies key areas of neonatal resuscitation-related research needed from LMICs to inform evidence-based resuscitation of neonates in LMICs.

scholarly journals Developing capacity-building activities for mental health system strengthening in low- and middle-income countries for service users and caregivers, service planners, and researchers

2017 ◽  
Vol 27 (1) ◽  
pp. 11-21 ◽  
Author(s):  
M. Semrau ◽  
A. Alem ◽  
J. Abdulmalik ◽  
S. Docrat ◽  
S. Evans-Lacko ◽  
...  
Keyword(s):  
Mental Health ◽  
Health System ◽  
Capacity Building ◽  
Mental Health System ◽  
Health System Strengthening ◽  
Target Groups ◽  
Middle Income ◽  
Middle Income Countries ◽  
Building Activities ◽  
Low And Middle Income

There is increasing international recognition of the need to build capacity to strengthen mental health systems. This is a fundamental goal of the ‘Emerging mental health systems in low- and middle-income countries’ (Emerald) programme, which is being implemented in six low- and middle-income countries (LMICs) (Ethiopia, India, Nepal, Nigeria, South Africa, Uganda). This paper discusses Emerald's capacity-building approaches and outputs for three target groups in mental health system strengthening: (1) mental health service users and caregivers, (2) service planners and policy-makers, and (3) mental health researchers. When planning the capacity-building activities, the approach taken included a capabilities/skills matrix, needs assessments, a situational analysis, systematic reviews, qualitative interviews and stakeholder meetings, as well as the application of previous theory, evidence and experience. Each of the Emerald LMIC partners was found to have strengths in aspects of mental health system strengthening, which were complementary across the consortium. Furthermore, despite similarities across the countries, capacity-building interventions needed to be tailored to suit the specific needs of individual countries. The capacity-building outputs include three publicly and freely available short courses/workshops in mental health system strengthening for each of the target groups, 27 Masters-level modules (also open access), nine Emerald-linked PhD students, two MSc studentships, mentoring of post-doctoral/mid-level researchers, and ongoing collaboration and dialogue with the three groups. The approach taken by Emerald can provide a potential model for the development of capacity-building activities across the three target groups in LMICs.

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