How to Save 1 Million Lives in a Year in Low- and Middle-Income Countries

Travers, Colm P.; Carlo, Wally

doi:10.1159/000460512

Cited by 16 publications

(15 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since mid-2017, a specific neonatal emergency hospital training program has provided details about how to follow the algorithm and implement it in MSF settings; training is a crucial component of any clinical visual aid and necessary to capitalize on potential reductions in mortality [33]. After the tool's initial rollout, further training materials will be created as needed per field feedback.…”

Section: Suctioning Of the Mouth And Oropharynxmentioning

confidence: 99%

When Helping Babies Breathe Is Not Enough: Designing a Novel, Mid-Level Neonatal Resuscitation Algorithm for Médecins Sans Frontières Field Teams Working in Low-Resource Hospital Settings

Umphrey

Breindahl

Brown³

et al. 2018

Neonatology

View full text Add to dashboard Cite

Background: Neonatal resuscitation (NR) combines a set of life-saving interventions in order to stabilize compromised newborns at birth or when critically ill. Médecins Sans Frontières/Doctors Without Borders (MSF), as an international medical-humanitarian organization working particularly in low-resource settings (LRS), assisted over 250,000 births in obstetric and newborn care aid projects in 2016 and provides thousands of newborn resuscitations annually. The Helping Babies Breathe (HBB) program has been used as formal guidance for basic resuscitation since 2012. However, in some MSF projects with the capacity to provide more advanced NR interventions but a lack of adapted guidance, staff have felt prompted to create their own advanced algorithms, which runs counter to the organization's aim for standardized protocols in all aspects of its care. Objectives: The aim is to close a significant gap in neonatal care provision in LRS by establishing consensus on a protocol that would guide MSF field teams in their practice of more advanced NR. Methods: An independent committee of international experts was formed and met regularly from June 2016 to agree on the content and design of a new NR algorithm. Results: Consensus was reached on a novel, mid-level NR algorithm in April 2017. The algorithm was accepted for use by MSF Operational Center Paris. Conclusion: This paper contributes to the literature on decision-making in the development of cognitive aids. The authors also highlight how critical gaps in healthcare delivery in LRS can be addressed, even when there is limited evidence to guide the process.

show abstract

Section: Suctioning Of the Mouth And Oropharynxmentioning

confidence: 99%

When Helping Babies Breathe Is Not Enough: Designing a Novel, Mid-Level Neonatal Resuscitation Algorithm for Médecins Sans Frontières Field Teams Working in Low-Resource Hospital Settings

Umphrey

Breindahl

Brown³

et al. 2018

Neonatology

View full text Add to dashboard Cite

show abstract

“…Globally around 2.6 million babies are stillborn every year and another 2.1 million live‐born babies die before the end of the first week of life . The vast majority occur in low and middle‐income countries (LMIC) . Data on stillbirth and early neonatal mortality in Timor‐Leste is limited.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 The vast majority occur in low and middle-income countries (LMIC). 3,4 Data on stillbirth and early neonatal mortality in Timor-Leste is limited. The Timor-Leste Demographic and Health Survey (TLDHS), a nationwide survey of selected households indicated a perinatal mortality rate (PNMR) of 20/1000 live births, a stillbirth rate of 3/1000 births and an early neonatal death rate of approximately 17/1000 live births.…”

Section: Introductionmentioning

confidence: 99%

A prospective review of perinatal mortality at Hospital Nacional Guido Valadares (HNGV)

Jayaratnam

Soares

Bucens

et al. 2019

Aust NZ J Obst Gynaeco

View full text Add to dashboard Cite

Background Timor‐Leste has one of the highest perinatal mortality rates in the Asia‐Pacific region. Consistent and accurate data collection improves understanding of perinatal outcomes and facilitates the development of interventions to reduce stillbirths and early neonatal deaths. Aims (1) To identify changes in the rates of stillbirth and early neonatal deaths from previous published data. (2) To determine if prospective data collection and the application of the simplified Causes Of Death and Associated Conditions (CODAC) classification allows better identification of perinatal deaths in Timor‐Leste. Methods A prospective audit of perinatal deaths of women delivering at Hospital Nacional Guido Valadares (HNGV) was undertaken from January to June 2016 inclusive. The hospital birth registry, maternal and neonatal records were reviewed to determine the most likely aetiology and classification of perinatal deaths using the simplified CODAC system. Results One hundred and ten stillbirths and 28 early neonatal deaths were identified. Fifty‐four percent of perinatal deaths occurred antepartum, 26% intrapartum and 20% were early neonatal deaths. Cause of death among stillbirths could not be ascertained in 40% of cases. Intrapartum asphyxia was the commonest identified aetiology of intrapartum and early neonatal deaths. Conclusion There has been limited improvement in the rate of stillbirths and early neonatal deaths at HNGV. Intrapartum hypoxia and maternal hypertensive conditions were the most common identified aetiologies highlighting areas where targeted interventions may help reduce high perinatal mortality rates. Aetiology of perinatal deaths, particularly antepartum stillbirths was difficult to discern even when well‐tested classification systems are used.

show abstract

“…Most neonatal deaths are due to complications related to preterm birth and low birth weight, or adverse intrapartum events, and occur at home or in low-technology health care facilities [21]. While enormous challenges exist for developing and implementing sustainable interventions to address this burden in low-income countries, notable advances have been made in some areas such as the reduction in global mortality from neonatal tetanus [22]. Priority areas for research to further reduce perinatal mortality and morbidity globally include interventions to promote skilled care during labour and childbirth (at both health care facilities and at home), reduce the risk of infection associated with umbilical cord care, support breastfeeding and “kangaroo mother care,” and improve the recognition and treatment of neonatal infections [23].…”

Section: Global Challenges For Perinatal Health Researchmentioning

confidence: 99%

The Research Cycle: Improving Care and Outcomes for Newborn Infants

McGuire

Halliday

2018

Neonatology

View full text Add to dashboard Cite

Ensuring that policies and practice in perinatal care are informed by evidence from high-quality research is fundamental to improving outcomes for newborn infants and their families. Effective interventions in the perinatal period can have a life-long impact disproportionate to their costs. Many of the major advances in care that have transformed outcomes for preterm and sick newborn infants have been informed by empirical and applied health research. Conversely, there are examples of life-long adverse consequences for infants and families that are a legacy of practices based on poor-quality evidence. The challenge in the 21st century is to maintain the trajectory of improvements in care and outcomes. This will most likely be achieved via marginal gains from new or improved care practices underpinned by a range of research approaches, from preclinical and laboratory-based empirical studies that uncover pathogenic pathways or therapeutic mechanisms, to large-scale, applied research such as multicentre, randomised controlled trials. This will involve the coordination and collaboration of research efforts globally. Strategies to develop and prioritise research questions need to involve parents and families. Given the context in which much perinatal research is conducted, particularly in emergency situations around the time of birth, robust and transparent ethics and governance frameworks are essential to maintain the trust and engagement of communities. An ethical imperative exists to ensure that research output is disseminated effectively, and that effective and cost-effective interventions are implemented and integrated within a cycle that audits and benchmarks good practice and outcomes, and informs research evidence-based continuous quality improvement. This is the first in a series of articles on research methodology in neonatal medicine to be published in Neonatology, in response to a request from trainee researchers. We introduce the series by describing the research cycle, in particular how it is applied in neonatal medicine. Subsequent articles will cover translational research, clinical trials, diagnostic tests, global challenges, and the ethical issues relating to neonatal/perinatal research.

show abstract

How to Save 1 Million Lives in a Year in Low- and Middle-Income Countries

Cited by 16 publications

References 17 publications

When Helping Babies Breathe Is Not Enough: Designing a Novel, Mid-Level Neonatal Resuscitation Algorithm for Médecins Sans Frontières Field Teams Working in Low-Resource Hospital Settings

When Helping Babies Breathe Is Not Enough: Designing a Novel, Mid-Level Neonatal Resuscitation Algorithm for Médecins Sans Frontières Field Teams Working in Low-Resource Hospital Settings

A prospective review of perinatal mortality at Hospital Nacional Guido Valadares (HNGV)

The Research Cycle: Improving Care and Outcomes for Newborn Infants

Contact Info

Product

Resources

About