ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.

based on previously published studies. Out of multiple other demographic and illness-related factors assessed, only having a secondary dengue infection was associated with a high risk of DHF (RR=3.077,95% CI 1.361, 6.954) Conclusion Persistent NS1 positivity on day three and beyond may not be indicative of disease severity. However, results need to be confirmed by a larger study with quantitative NS1 testing.

Objective Paediatric Assessment Illness Resuscitation and Stabilisation Course (PAIRS) is an accredited one day course developed in Dublin for resource limited settings. The aim of this project was to deliver this course to front line paediatric staff in a south eastern Nigerian hospital. Methods The course was delivered over 8 hours daily for 3 days with breaks in-between. On the 4th day, a number of delegates including doctors and senior nurses who had attended one of the 3 days were invited to participate in a more intensive course to develop more advanced skills in paediatric resuscitation and management of sick children. Delegates' knowledge was tested and they received certificates of completion at the end of the course. Results Over the 4 days, 214 paediatric healthcare workers (136 doctors, 77 nurses, 1 'other') representing 21 hospitals were trained on a structured approach in the assessment and resuscitation of serious illness in children, team work and communication, paediatric early warning system and basic life support. Delegates reported increased knowledge and competency in the management of paediatric emergencies. Conclusion The World Health Organisation (WHO) estimates that about five children under 5 years of age die in Africa every minute. More than half of these child deaths are due to conditions that are preventable or treatable with simple interventions. Teaching paediatric resuscitation enhances the skills of paediatric responders and has been shown to directly reduce morbidity and improve patient survival. This course enhanced their knowledge and helped the participants formulate tools required for early recognition and monitoring of illness progression in paediatric patients. On completion of the course, a local faculty was also instated to commence simulation training in the local hospital with support from the Ireland faculty. The training was well received and had a lot of positive feedback.

Background Neonatal mortality remains unacceptably high. Many studies successful at reducing neonatal mortality have failed to realise similar gains at scale. Effective implementation and scale-up of interventions designed to tackle neonatal mortality is a global health priority. Multifaceted programmes targeting the continuum of neonatal care, with sustainability and scalability built into the design, can provide practical insights to solve this challenge. Cambodia has amongst the highest neonatal mortality rates in South-East Asia, with rural areas particularly affected. The primary objective of this study is the design, implementation, and assessment of the Saving Babies’ Lives programme, a package of interventions designed to reduce neonatal mortality in rural Cambodia. Methods This study is a five-year stepped-wedge cluster-randomised trial conducted in a rural Cambodian province with an estimated annual delivery rate of 6615. The study is designed to implement and evaluate the Saving Babies’ Lives programme, which is the intervention. The Saving Babies’ Lives programme is an iterative package of neonatal interventions spanning the continuum of care and integrating into the existing health system. The Saving Babies’ Lives programme comprises two major components: participatory learning and action with community health workers, and capacity building of primary care facilities involving facility-based mentorship. Standard government service continues in control arms. Data collection covering the whole study area includes surveillance of all pregnancies, verbal and social autopsies, and quality of care surveys. Mixed methods data collection supports iteration of the complex intervention, and facilitates impact, outcome, process and economic evaluation. Discussion Our study uses a robust study design to evaluate and develop a holistic, innovative, contextually relevant and sustainable programme that can be scaled-up to reduce neonatal mortality. Trial registration ClinicalTrials.gov: NCT04663620. Registered on 11th December 2020, retrospectively registered.