Facility and care provider emergency preparedness for neonatal resuscitation in Kano, Nigeria

Introduction The knowledge, attitude, and practice of emergency neonatal resuscitation are critical requirements in any facility that offers obstetric and neonatal services. This study aims to conduct a needs assessment survey and obtain individual and facility-level data on expertise and readiness for neonatal resuscitation. We hypothesize that neonatal emergency preparedness among healthcare providers in Kano, Nigeria is associated with the level of knowledge, attitudinal disposition, practice and equipment availability at the facility level. Methods A semi-structured, self-administered questionnaire was administered to a cross-section of health providers directly involved with neonatal care (n = 112) and attending a neonatal resuscitation workshop in Kano state. Information regarding knowledge, attitude, practice and facility preparedness for neonatal resuscitation was obtained. Bloom’s cut-off score and a validated basic emergency obstetric and neonatal care assessment tool were adopted to categorize outcomes. Multivariable logistic regression was employed to determine independent predictors of knowledge and practice. Results Almost half (48% and 42% respectively) of the respondents reported average level of self-assessed knowledge and comfort during resuscitation. Only 7% (95% CI:3.2–13.7) and 5% (95% CI:2.0–11.4) of health providers demonstrated good knowledge and practice scores respectively, with an overall facility preparedness of 46%. Respondents’ profession as a physician compared to nurses and midwives predicted good knowledge (aOR = 0.08, 95% CI: 0.01–0.69; p = 0.01), but not practice. Conclusion Healthcare provider’s knowledge and practice including facility preparedness for emergency neonatal resuscitation were suboptimal, despite the respondents’ relatively high self-assessed attitudinal perception. Physicians demonstrated higher knowledge compared to other health professionals. The low level of respondents’ awareness, practice, and facility readiness suggest the current weak state of secondary health systems in Kano.

Comparative Study of Knowledge of Urban and Rural Mothers about Neonatal Care

Objectives: The purpose of this study is to assess and compare the knowledge about the neonatal care among the mothers in urban and rural area in district Ajmer province of Rajasthan Materials and methods: Comparative randomized descriptive study was conducted among mothers who willingly gave consent to participate in the study. A structured questionnaire were framed and mothers were interviewed, the answers were recorded. To judge the knowledge score of the mothers closed ended questions having four alternatives were also framed. One mark was allocated for correct response. Results: Among 5800 deliveries, 400 mothers (205 mothers were Urban and 195 mothers were from Rural area) were randomly selected. Mothers with Antenatal check-up had knowledge score of 61% compared to 24% who had no regular antenatal checkup. Knowledge about “Exclusive Breastfeeding” was 84.39% and 68.20% urban mothers and rural mothers and regarding adequacy was 73.17% in Urban and 44.61% in rural mothers. Knowledge about Hygiene was 89.75% and 53.33% in Urban and rural mothers. Skin care and baby bath was 28.29% and 18.46% in Urban and Rural mothers respectively. Knowledge about danger signs was 81.95% and 60% in Urban and Rural mothers respectively. Knowledge regarding immunization at birth was 70.7% and 35.89% in Urban and Rural mothers respectively. Conclusions: Main factors affecting the knowledge score of the mothers about neonatal care were Educational status and Antenatal checkup. Knowledge about adequacy of breastfeeding, Immunization at birth, Danger signs, Temperature maintenance and hygiene was less in rural mothers as compared to urban mothers.

Telemedicine in neonatal care-Saving lives with technology!

Madam, neonatal mortality in Pakistan i.e. death of babies within first twenty eight days of life is 49 per 1000 live births. Moreover, Pakistan contributes to 7% of global neonatal deaths. (1) Cause of mortality may be infection, intra-partum complications, prematurity or congenital birth defects but there is one thing common in all; majority of them occur in rural population due to lack of access to health care facilities. (2) With recent advances, role of tele-medicine has proved to be a milestone in field of medicine especially in underdeveloped and rural areas. According to World Health Organization (WHO), Telemedicine is defined as affordable use of Information and Communication Technology (ICT) for provision of health facilities and care. (3) A study done in Karachi in early 2020 by Ashfaq A et al showed average knowledge of telemedicine among clinicians and junior doctors, but we are still hopeful that since after the global pandemic of COVID-19, not just this knowledge has improved but also perceptions regarding telemedicine should have changed (4). In another study done in china by Makkar A. et al, they demonstrated the role of tele-medicine in not just tele-rounds of NICU but also successful e-examinations of Retinopathy of prematurity, tele-echocardiography, tele-NPR guidance to healthcare providers and family support. Moreover, home based care can be efficiently provided to preterm low birth weight babies including establishment of enteral feeding. (5) With a global shortage of physicians worldwide, lack of neonatologists is a major reason of neonatal referrals from rural areas and tele-medicine can give promising results in this regard. It can not only prevent unnecessary ambulation of tiny patients but also improve survival and quality care. Though under umbrella of private NGOs, tele-medicine is being started for satellite centers in few regions of country but obviously it doesn’t cover majority of population. It is high time to realize importance of Tele-medicine in periphery care setups. Though provision of equipment, installments of high quality ICT and infrastructure might seem a barrier in establishment of Tele-medicine but it can bring revolutionary improvement in neonatal care. It cannot just help reducing over burdening to tertiary care hospitals but also in avoiding hazards and cost of patient transfer.

NEONATUS DENGAN IKTERIK

Sampai saat ini ikterus masih merupakan masalah pada neonatus yang sering dihadapi tenaga kesehatan terjadi pada sekitar 25-50% neonatus cukup bulan dan lebih tinggi pada neonatus kurang bulan.Oleh sebab itu memeriksa ikterus pada neonatus harus dilakukan pada waktu melakukan kunjungan neonatal/pada saat memeriksa bayi diklinik. Desaign Penelitian ini menggunakan Studi kasus, dilakukan untuk melakukan identifikasi asuhan kebidanan neonatus secara komprehensif dalam Neonatal Care. Sampel yang di ambil adalah neonatus dalam asuhan di PMB Sulastri, S.ST. Metode penelitian ini menggunakan metode observasi dan dengan cara deskriptif. Observasi yang dilakukan menggunakan pola pikir Varney dan pendokumentasian dalam bentuk SOAP. Hasil studi kasus menunjukan pelaksanaan Asuhan Kebidanan Neonatus dengan Ikterus yang dilakukan dengan pemberian asuhan sesuai standart operasional prosedur serta melakukan pencegahan komplikasi yang lain pada saat proses kunjungan neonatus.

Perinatal and Early Childhood Development

This chapter looks at the systems approach in addressing the dilemma of investing in neonatal health in resource constraints environment. Is investing in neonatal care the key to attaining sustainable development goals? Is it just or even just to invest in Neonatal care in the midst of competing interests? It applies causal loop diagrams as part of systems dynamics approach in seeking to identify the intended and intended consequences of investing in Neonatal Health. A look into countries have done well in Neonatal health and their investment early childhood education is done in order to give insight into the relationship between the investments.