Every Preemie: Situation Analysis of Inpatient Care of Newborns and Young Infants

Victor Otieno is a new father to twins and is successfully completeing KMC which relieves the burden on his wife. Save the Children is strengthening the skills and capacity of health providers in seven hospitals located in the Langata area of Nairobi, Kenya, so that they can deliver higher quality care to preterm and low-birth-weight babies. The project is targeting to reach 2,200 new born babie each year. Kangaroo Mother Care (KMC) is the current recommended practice to care for stable preterm babies in Kenya. For babies, KMC promotes faster weight gain due to better thermoregulation and improved breastfeeding and therefore shorter hospital stay. KMC improves bonding between mother and baby and empowers mothers to play an active role in care for the newborn. KMC reduces dependency on incubators, does not require additional nursing staff and reduces cost per patient due to shorter hospital stays providing benefits for the health facility.

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In 2017 Every Preemie led the development of a protocol and tools for a situation analysis to provide a better understanding of the landscape of inpatient care for small and sick newborns in low- and middle-income countries. The aim of this analysis is to assess service readiness and quality of care by examining health system structures, facility processes, national policies and clinical standards and parent/caregiver experience for inpatient care of small and sick newborns in a range of countries. The protocol and tools, country implementation guide, and tabulation templates are available for download from the Every Preemie website: https://www.everypreemie.org/situation-analysis/.

The situation analysis protocol was designed by a multi-partner core team including USAID, the Maternal and Child Survival Program (MCSP), Saving Newborn Lives (SNL), UNICEF, WHO, the URC ASSIST Project, the London School of Hygiene & Tropical Medicine (LSHTM) and the Global Health Supply Chain Project at Chemonics. A broader advisory group consisting of additional representatives from the organizations above as well as the Knowledge Management Services Project and the Bill & Melinda Gates Foundation (BMGF) was engaged to provide input to the draft protocol and tools. The materials were finalized in early 2017 after pretesting in two countries.

In 2018 and 2019, the situation analysis was implemented by partners in Bangladesh, Ghana, Nepal, Pakistan, Rwanda, Tanzania, and Uganda. Every Preemie then developed a multi-country summary to provide an overview of key findings for the countries with available data at the time of its development: Ghana, Rwanda, Tanzania, and Uganda. This multi-country summary is also available at the above link and features country demographic data; the types and numbers of facilities included by country; available policies, guidelines, strategies and standards of care for inpatient newborns; service readiness and availability; elements of nurturing care; and data available through Ministry of Health facility registers. Ministries of Health and other stakeholders will use their comprehensive findings to inform policy and guidelines, and service delivery and related inputs for improved inpatient care of newborns and young infants.

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