scholarly journals Gaps in neonatal thermal care in low-resource settings: A web-based survey of healthcare workers.

2021 ◽  
Author(s):  
Michiko Kyokan ◽  
Veena Jirapaet ◽  
Flavia Rosa-Mangeret ◽  
Giorgia Brambilla Pisoni ◽  
Riccardo E Pfister
Keyword(s):  
Cold Stress ◽  
Healthcare Workers ◽  
Neonatal Care ◽  
Multiple Choice Questions ◽  
Axillary Temperature ◽  
Web Based ◽  
Low Resource Settings ◽  
Low Resource ◽  
Thermal Care ◽  
Peripheral Temperature

Abstract Objective To explore the gaps in knowledge and practice in neonatal thermal care among healthcare workers in low-resource settings. Methods We conducted a 2-round, web-based survey of a purposive and snowball sample of healthcare workers in neonatal care in low-resource settings globally. The questionnaire was developed using themes of neonatal thermal care extracted from existing neonatal care guidelines, including WHO’s. The survey asked multiple-choice questions, supplemented by open-ended questions to capture first hand insights and information on neonatal thermal care. Results of the survey were analysed using Microsoft Excel. Data was collated and summarized using descriptive measures. Results Almost all participants acknowledged the importance of all the WHO warm chain elements, however, fewer participants responded positively regarding the practice of this warm chain. Only 56% of the participants acknowledged the usefulness of checking the peripheral temperature by hand-touch. The usefulness of the core temperature was valued higher than that of the peripheral temperature as an indicator of cold stress, with 70% and 58% agreement, respectively. Opinions diverged regarding the peripheral temperatures, including apparent inaccuracy compared to rectal or axillary temperature. Preferences on rewarming strategies widely differed among participants and so did the availability of warming equipment in their institutions. Conclusions We identified the general acknowledgment of the importance of the WHO warm chain but also its limited practice. We also identified that an inadequate understanding of cold stress underestimates the potential benefits of peripheral temperatures and leads to missed opportunities for timely prevention of hypothermia. Furthermore, lack of consistent guidance on equipment for rewarming hypothermic neonates hampers recovery.

Design of a Novel Mechanical Syringe Pump for Neonatal Care in Low-Resource Settings

2011 ◽  
Author(s):  
Cynthia Sung ◽  
Rashmi R. Kamath ◽  
Yiwen Cui ◽  
Clare Ouyang ◽  
Elizabeth Carstens ◽  
...  
Keyword(s):  
Neonatal Care ◽  
Syringe Pump ◽  
Low Resource Settings ◽  
Low Resource

scholarly journals Peer- and Mentor-Enhanced Web-Based Training on Substance Use Disorders: A Promising Approach in Low-Resource Settings

2019 ◽  
Vol 70 (11) ◽  
pp. 1068-1071
Author(s):  
Veronic Clair ◽  
Verena Rossa-Roccor ◽  
Aggrey G. Mokaya ◽  
Victoria Mutiso ◽  
Abednego Musau ◽  
...  
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Web Based ◽  
Low Resource Settings ◽  
Low Resource

scholarly journals Staged implementation of a two-tiered hospital-based neonatal care package in a resource-limited setting in Eastern Uganda

2018 ◽  
Vol 3 (1) ◽  
pp. e000586 ◽  
Author(s):  
Kathy Burgoine ◽  
Juliet Ikiror ◽  
Sylivia Akol ◽  
Margaret Kakai ◽  
Sara Talyewoya ◽  
...  
Keyword(s):  
Neonatal Mortality ◽  
Low Income ◽  
Low Cost ◽  
Neonatal Care ◽  
Health Facilities ◽  
Low Income Countries ◽  
Low Resource Settings ◽  
Low Resource ◽  
Care Package ◽  
Eastern Uganda

Neonatal mortality remains a major global challenge. Most neonatal deaths occur in low-income countries, but it is estimated that over two-thirds of these deaths could be prevented if achievable interventions are scaled up. To date, initiatives have focused on community and obstetric interventions, and there has been limited simultaneous drive to improve neonatal care in the health facilities where the sick neonates are being referred. Few data exist on the process of implementing of neonatal care packages and their impact. Evidence-based guidelines for neonatal care in health facilities in low-resource settings and direction on how to achieve these standards of neonatal care are therefore urgently needed. We used the WHO-Recommended Quality of Care Framework to build a strategy for quality improvement of neonatal care in a busy government hospital in Eastern Uganda. Twelve key interventions were designed to improve infrastructure, equipment, protocols and training to provide two levels of neonatal care. We implemented this low-cost, hospital-based neonatal care package over an 18-month period. This data-driven analysis paper illustrates how simple changes in practice, provision of basic equipment and protocols, ongoing training and dedicated neonatal staff can reduce neonatal mortality substantially even without specialist equipment. Neonatal mortality decreased from 48% to 40% (P=0.25) after level 1 care was implemented and dropped further to 21% (P<0.01) with level 2 care. In our experience, a dramatic impact on neonatal mortality can be made through modest and cost-effective interventions. We recommend that stakeholders seeking to improve neonatal care in low-resource settings adopt a similar approach.

scholarly journals Flat-pack, rapid production powered air purifying respirators for Low-Resource Settings amid the SARS-CoV-2 pandemic

2020 ◽  
Author(s):  
Antonio De Grazia ◽  
Laura Diment ◽  
Constantinos Regas ◽  
Sebastian Rosini ◽  
Diana Garay Baquero ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Low Cost ◽  
Positive Pressure ◽  
Low Resource Settings ◽  
Low Resource ◽  
Airborne Infection ◽  
Healthcare Settings ◽  
Fit Testing ◽  
The Face ◽  
Single Use

Healthcare workers are at high risk of catching SARS-CoV-2 because of their regular interaction with patients with the disease. In low-resource settings, the ratio of healthcare workers to the whole population is lower than in high income countries, and there is often limited access to personal protective equipment (PPE). Illness or death of healthcare workers will, therefore, have a disproportionate impact in these settings, so it is particularly important to find ways to protect them.To protect against airborne infection in healthcare settings, PPE recommendations typically include filtering facemask respirators or powered air purifying respirators (PAPR). The former, passively filter inhaled air. They are small, noiseless and do not require a power supply, but they are single-use, presenting manufacturing and supply issues. Fit testing is crucial, and many users find them difficult to tolerate, due to breathing resistance and elevated humidity. There is also the potential for contamination due to the exposed face. PAPRs are re-usable devices that may last for months and provide airflow through a filter from a battery-powered blower unit to a hood or helmet which covers the face. This creates a positive pressure in the hood or helmet that enables the wearer to breathe filtered air easily, without requiring an air-tight fit needed for standard face masks. This is reported to be more comfortable and provides better protection for the face from droplets and splashes, and infection by self-contact with the hands. PAPRs have typically been expensive, bulky and not readily available or easy to ship to low-resource settings.Although the design presented here has not been through any form of regulatory approval, the aim of this paper is to share ideas and offer possible solutions to other groups around the World who may be thinking of manufacturing a low-cost, reusable PAPR. The design is novel because it uses readily available materials, scalable manufacturing processes, and it may be shipped flat-packed and easily assembled. This offers an option for manufacturing in low-resource settings and for shipping in bulk. This paper provides the CAD designs that can be fabricated using a laser cutter.

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