Advancing Survival in Nigeria: A Pre-post Evaluation of an Integrated Maternal and Neonatal Health Program

Sloan, Nancy L.; Storey, Andrew; Fasawe, Olufunke; Yakubu, Jamila; McCrystal, Kelly; Wiwa, Owens; Lothe, Lene Jeanette; Grepstad, Mari

doi:10.1007/s10995-018-2476-3

Cited by 16 publications

(27 citation statements)

References 25 publications

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“…27 Despite these global recommendations and endorsements and despite pilot implementation and scale up projects conducted in India Nigeria, Ethiopia, Niger, Timor Leste and Colombia, there have been fewer publications on how the NASG is accepted and used by clinicians and health systems. [28][29][30][31][32][33][34][35] The reports on NASG use in Purina and Gaya district from Bihar revealed that the interviews and discussion with stakeholders reflected that even after training and appropriate introduction of the practice of using the NASG, the initiative did not translate into making a difference in ameliorating the situation of PPH management in the health facilities over a period of the following 6 months. The NASG were procured by national health mission and supplied in ambulances to the facilities.…”

Section: Discussionmentioning

confidence: 99%

Use of non-pneumatic anti shock garment in hemorrhagic shock

Bangal¹,

Gavhane²,

Raut³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Non-pneumatic anti-shock garment (NASG) is a first-aid device that reverses hypovolemic shock and decreases obstetric haemorrhage. It consists of articulated neoprene segments that close tightly with Velcro, shunting blood from the lower body to the core organs, elevating blood pressure and increasing preload and cardiac output. The use of an NASG can stabilize a patient while awaiting transport, during transport, or during delays in receiving care at referral facilities.Methods: A prospective observational study of use of non-pneumatic anti shock garment (NASG) in cases with obstetric hemorrhagic shock was carried out at a tertiary referral center. As soon as severe shock was recognized in the hospital, the anti-shock garment was placed. Data on various parameters related to use of NASG was collected and interpreted to draw conclusions.Results: NASG was used in 25 cases of hemorrhagic shock during one-year period. Post-partum hemorrhage (36%) was the commonest indication for NASG use, followed by ruptured tubal ectopic pregnancy (28%). It was observed that 68% and 32 % of women had shock index of 1-1.5 and above 1.5 respectively at the time of application of NASG. The shock index rapidly improved to 0.5-0.9 in 92% and 1-1.5 in 8 percent of cases respectively after the application of NASG. The NASG was mainly used in labour room (40%) and emergency department (36%). NASG was applied by nurses and doctors together in 64% of cases. NASG was kept for a period 24 hours in 92% cases. The survival rate was 96% following use of NASG.Conclusions: NASG is a temporizing alternative measure in hemorrhagic shock management that shows a trend to reduce hemorrhage related deaths and severe morbidities. NASG should be made available at all health facilities that deal with high risk pregnancies and deliveries.

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Section: Discussionmentioning

confidence: 99%

Use of non-pneumatic anti shock garment in hemorrhagic shock

Bangal¹,

Gavhane²,

Raut³

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…[4,5] Neonatal deaths and stillbirths have declined at a slower rate than other under-5 deaths. [6,7,8] Therefore, more concentration is needed on the neonatal population, which is part of Sustainable Development Goals (SDG), specifically (SDG 3.2).Birth asphyxia, perinatal asphyxia, and neonatal asphyxia are all terms referring to the same neonatal complication of a hypoxic event before, during or shortly after birth. [4,9,10,11] Birth asphyxia is not just a medical diagnosis, but also a nursing and midwifery concern, as the standard neonatal care after birth is prompt drying, stimulation and warmth, which is sufficient intervention to initiate and maintain breathing for 99% of neonates.…”

Section: Introductionmentioning

confidence: 99%

Birth asphyxia at a district hospital in Kigali, Rwanda

Uwingabire¹,

Gowan²

2019

Rwanda Journal of Medicine and Health Sciences

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_________________________________________________________ AbstractBackground Prematurity, birth asphyxia (BA), and sepsis are the leading causes of neonatal mortality. The BA prevalence rate is 23% worldwide and affects up to 39% in Rwanda. Birth asphyxia is an insult with significant consequences to the neonate's brain and other vital organs due to decreased oxygen before, during or immediately after birth. Objective To assess the BA prevalence, associated factors, and outcomes at a district hospital in Kigali. Methods A retrospective, cross-sectional study of 340 neonates admitted to the NICU in 2016. ResultsBirth asphyxia was identified in 135 out of 340 newborns (39.7%). Associated factors included gravida, meconium-stained amniotic fluid, normal duration of labor, normal duration of ROM, vaginal delivery, Apgar score of ≤5 at 5 minutes, respiratory ventilation and cardiac massage and normal birth weight (2500-3999gr). Two-thirds were born via vaginal birth (66.5%), and nearly half (47.3%) had BA. One-third was born via cesarean (33.5%), and a quarter (24.6%) had BA. Other BA outcomes included prolonged hospitalization beyond the neonatal period at 75% compared to non asphyxiated babies (25%). The mean days of NICU stay was 7.6 (SD: 6.1) for BA while it was 5.3 (SD: 4.16) for non-asphyxiated babies; early seizures (52.6%) and high specific mortality (87%). DiscussionFindings revealed a 6% BA prevalence increase, and a BA-specific mortality rate 13 times higher than previously recorded. Trained healthcare professionals need to reverse this significant trend in both vaginal and cesarean births that likely has a profound effect on the neonate, family, and community.Rwanda J Med Health Sci 2019;2(2):96-104. ________________________________________________________________________

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“…Efforts to include CHWs and traditional birth attendants into NOC provide important examples of both features. 66,67 Extending the reach of NOC is especially important when the network aims to provide services to hard-toreach and underserved groups, such as people in rural areas, those living in extreme poverty, or experiencing other circumstances that increase their vulnerability to poor health outcomes. Vulnerable groups are likely to have less agency to navigate poorly integrated nodes of a nominal network, so methods that diversify locations of care, bring care closer to where they reside, or otherwise emphasize and facilitate continuity of care, can save lives.…”

Section: Flexibility and Extending Reachmentioning

confidence: 99%

Developing a Common Understanding of Networks of Care through a Scoping Study

Carmone

Kalaris

Leydon

et al. 2020

Health Systems & Reform

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The phrase "Networks of Care" seems familiar but remains poorly defined. A health system that exemplifies effective Networks of Care (NOC) purposefully and effectively interconnects service delivery touch points within a catchment area to fill critical service gaps and create continuity in patient care. To more fully elaborate the concept of Networks of Care, we conducted a multimethod scoping study that included a literature review, stakeholder interviews, and descriptive case studies from five low-and middle-income countries. Our extended definition of a Network of Care features four overlapping and interdependent domains of activity at multiple levels of health systems, characterized by: 1) Agreement and Enabling Environment, 2) Operational Standards, 3) Quality, Efficiency and Responsibility, and 4) Learning and Adaptation. There are a series of key interrelated themes within each domain. Creating a common understanding of what characterizes and fosters an effective Network of Care can drive the evolution and strengthening of national health programs, especially those incorporating universal health coverage and promoting comprehensive care and integrated services. An understanding of the Networks of Care model can help guide efforts to move health service delivery toward goals that can benefit a diversity of stakeholders, including a variety of health system actors, such as health care workers, users of health systems, and the wider community at large. It can also contribute to improving poor health outcomes and reducing waste originating from fragmented services and lack of access.

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Advancing Survival in Nigeria: A Pre-post Evaluation of an Integrated Maternal and Neonatal Health Program

Cited by 16 publications

References 25 publications

Use of non-pneumatic anti shock garment in hemorrhagic shock

Use of non-pneumatic anti shock garment in hemorrhagic shock

Birth asphyxia at a district hospital in Kigali, Rwanda

Developing a Common Understanding of Networks of Care through a Scoping Study

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