{"id":46214,"date":"2020-08-28T09:15:20","date_gmt":"2020-08-28T13:15:20","guid":{"rendered":"https:\/\/www.healthynewbornnetwork.org\/?post_type=resource&p=46214"},"modified":"2020-08-27T11:18:25","modified_gmt":"2020-08-27T15:18:25","slug":"feasibility-of-implementation-of-simplified-management-of-young-infants-with-possible-serious-bacterial-infection-when-referral-is-not-feasible-in-tribal-areas-of-pune-district-maharashtra-india","status":"publish","type":"resource","link":"https:\/\/www.healthynewbornnetwork.org\/resource\/feasibility-of-implementation-of-simplified-management-of-young-infants-with-possible-serious-bacterial-infection-when-referral-is-not-feasible-in-tribal-areas-of-pune-district-maharashtra-india\/","title":{"rendered":"Feasibility of implementation of simplified management of young infants with possible serious bacterial infection when referral is not feasible in tribal areas of Pune district, Maharashtra, India"},"content":{"rendered":"
\n

Introduction<\/h2>\n

Neonatal infections are a common cause of death in India, but many families cannot access appropriate hospitals for its treatment due to various reasons. Researchers implemented the World Health Organization PSBI management guideline when referral is not feasible within the public health system in Pune, India to evaluate feasibility, barriers and facilitators for its implementation.<\/p>\n

Methods<\/h2>\n<\/div>\n

A national-level consultative meeting between government officials and study partners resulted in a consensus on adaptation and implementation in four demonstration sites in selected states in India. At the state and district levels, similar meetings to plan the implementation strategy and roles were held between KEM Hospital Research Centre (KEMHRC) Pune and the public health system Pune, Maharashtra. The public health system was responsible for implementation of the intervention at eight tribal primary health centres (PHC) in Pune district, India, including delivering the intervention and ensuring supplies of all commodities while KEMHRC was responsible for technical support including training of health workers, assistance in PSBI identification and management, data collection and documentation of the implementation strategy.<\/p>\n

\n

Results<\/h2>\n

A total of 175 young infants with PSBI were identified and managed. Of these, 34 had critical illness (CI), 46 had clinical severe infection (CSI) and 10 were infants aged 0\u20136 days with fast breathing (FB) while 85 infants aged 7\u201359 days had fast breathing. Assuming a 10% incidence of PSBI among all live births, with 3071 live births recorded, the actual incidence of PSBI found in the study was 5.7%, resulting in an actual coverage was of 57%. Among the 90 infants with CI, CSI and FB in 0\u20136 days, who were advised referral to government tertiary care centre as per the PSBI guideline algorithm, 81 (90%) accepted referral while 9 (10%) refused and were offered treatment at primary health centres (PHC) with a seven-day course of injectable gentamicin and oral amoxicillin. All infants with FB in 7\u201359 days were offered treatment at PHCs as per the PSBI guideline algorithm with a seven-day course of oral amoxicillin. All except six infants who died and one with FB in 7\u201359 days, who was lost to follow-up, were successfully cured. Of the six who died, five had CSI and one had CI. Among the 81 infants with CI, CSI and FB in 0\u20136 days who accepted referral; 48(53%) were successfully referred to government tertiary facility while 33 (36.6%) preferred to visit a private tertiary health facility. The implementation strategy demonstrated a relatively high fidelity, acceptance and intervention penetration. Lack of training and confidence of the public health staff were major challenges faced, which were resolved to a large extent through supportive supervision and re-trainings.<\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Introduction Neonatal infections are a common cause of death in India, but many families cannot access appropriate hospitals for its treatment due to various reasons. 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of implementation of simplified management of young infants with possible serious bacterial infection when referral is not feasible in tribal areas of Pune district, Maharashtra, India"}]},{"@type":"WebSite","@id":"https:\/\/www.healthynewbornnetwork.org\/#website","url":"https:\/\/www.healthynewbornnetwork.org\/","name":"Healthy Newborn Network","description":"Addressing critical knowledge gaps in newborn health.","potentialAction":[{"@type":"SearchAction","target":{"@type":"EntryPoint","urlTemplate":"https:\/\/www.healthynewbornnetwork.org\/?s={search_term_string}"},"query-input":"required name=search_term_string"}],"inLanguage":"en-US"}]}},"featured_image":"<img width=\"437\" height=\"530\" src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/feasibility.png\" class=\"attachment-medium_large size-medium_large\" alt=\"\" decoding=\"async\" srcset=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/feasibility.png 437w, https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/feasibility-247x300.png 247w\" sizes=\"(max-width: 437px) 100vw, 437px\" \/>","author_name":"HNN Team","author_image":"<img src=\"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/themes\/hnn\/dist\/images\/member-default.jpg\" alt=\"\" class=\"avatar avatar-32 photo\" height=\"32\" width=\"32\"\/>","acf_custom_fields":{"publication_date":"20200824","authors":false,"additional_authors":"Sudipto Roy, Rutuja Patil, Aditi Apte,Kavita Thibe, Arun Dhongade, Bhagawan Pawar, Yasir Bin Nisar, Samira Aboubaker, Shamim Ahmad Qazi, Rajiv Bahl, Archana Patil, Sanjay Juvekar, Ashish Bavdekar","type":"articles","language":["en"],"external_links":[{"link":""}],"files":[{"file":"https:\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/journal.pone_.0236355.pdf"}],"partners":[],"other_organizations":"","issues":[{"ID":411,"post_author":"7211","post_date":"2016-01-20 18:01:00","post_date_gmt":"2016-01-20 18:01:00","post_content":"[vc_row full_width=\"stretch_row\" css=\".vc_custom_1453403441710{margin-top: -60px !important;padding-top: 30px !important;padding-bottom: 30px !important;background-color: #ffffff !important;}\"][vc_column width=\"1\/2\"][vc_column_text]\r\n<h2>Identification of possible serious bacterial infection (PSBI) and timely initiation of appropriate antibiotic treatment can dramatically increase a newborn\u2019s chance of survival.<\/h2>\r\nRecent research has shown that when hospitalization is not possible, a safe, effective, and simpler antibiotic treatment can be provided in lower-level facilities.[\/vc_column_text][\/vc_column][vc_column width=\"1\/2\" el_class=\"issue-stats\"][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-red\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">600<\/span>k<\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666120914939{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">number of <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241512930\">neonatal deaths attributed to severe infections<\/a> annually<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner el_class=\"text-yellow\" width=\"1\/3\"][vc_column_text]\r\n<h1 style=\"text-align: center;\"><strong><span class=\"ticker\">10<\/span><\/strong><\/h1>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"2\/3\"][vc_column_text css=\".vc_custom_1666120847543{padding-top: 10px !important;padding-bottom: 10px !important;}\"]\r\n<h3 style=\"text-align: center;\"><span style=\"font-weight: 400;\">percent of newborns who <a href=\"https:\/\/www.who.int\/publications\/i\/item\/9789241512930\">develop signs of PSBI and require treatment<\/a>\u00a0<\/span><\/h3>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_separator][vc_row_inner content_placement=\"middle\"][vc_column_inner][vc_column_text]\r\n<h6 style=\"text-align: center;\"><span style=\"font-style: italic;\">All data on this page represents the most recent data available, unless otherwise noted. Please visit our\u00a0<\/span><a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\"><span style=\"font-style: italic;\">Newborn Numbers<\/span><\/a><span style=\"font-style: italic;\">\u00a0page and download the Excel spreadsheet to explore the data further.<\/span><\/h6>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][\/vc_column][\/vc_row][vc_row css=\".vc_custom_1455919301204{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_column][vc_column_text]\r\n<h2><b>PSBI Community of Practice <\/b><strong>(CoP)<\/strong><\/h2>\r\nThe PSBI CoP defines itself as \u201cgroups of people who share a concern or passion for something they do and learn how to do it better as they interact regularly.\u201d These groups facilitate the collective pursuit of a shared interest through relationship building, learning and information sharing about a specific practice area or need. They also stimulate dialogue, capture and diffuse existing knowledge, support collaboration, organize members around purposeful action, generate new knowledge and help to connect people who might not ordinarily interact. Given these features, COPs are uniquely positioned to help drive the research-to-use process by supporting stakeholder engagement, knowledge management, research translation, and research dissemination.[\/vc_column_text][vc_text_separator title=\"Key resources\"][vc_column_text]\r\n<ul>\r\n \t<li><a href=\"http:\/\/apps.who.int\/iris\/bitstream\/10665\/181426\/1\/9789241509268_eng.pdf\">Managing possible serious bacterial infection in young infants when referral is not feasible.<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/operationalizing-management-of-sick-young-infants-with-possible-serious-bacterial-infection-psbi-when-referral-is-not-feasible-in-the-context-of-existing-maternal-newborn-and-child-health-programm\/\">Operationalizing management of sick young infants with possible serious bacterial infection (PSBI) when referral is not feasible in the context of existing maternal, newborn, and child health programmes<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/pdfs\/journals\/langlo\/PIIS2214-109X(14)70347-X.pdf\">Safety and efficacy of alternative antibiotic regimens compared with 7-day injectable procaine benzyl penicillin and gentamicin for outpatient treatment of neonates and young infants with clinical signs of severe infection when referral is not possible: a randomized, open-label, equivalence trial.<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62284-4\/abstract\">Simplified antibiotic regimens compared with injectable procaine benzyl penicillin plus gentamicin for treatment of neonates and young infants with clinical signs of possible serious bacterial infection when referral is not possible: a randomized, open-label, equivalence trial.<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62285-6\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\">Oral amoxicillin compared with injectable procaine benzyl penicillin plus gentamicin for treatment of neonates and young infants with fast breathing when referral is not possible: a randomized, open-label, equivalence trial<\/a><\/li>\r\n \t<li><a href=\"http:\/\/www.thelancet.com\/journals\/lancet\/article\/PIIS0140-6736(14)62285-6\/abstract\" target=\"_blank\" rel=\"noopener noreferrer\"> Outpatient treatment for neonates and young infants with clinically suspected severe infection<\/a><\/li>\r\n \t<li><a href=\"https:\/\/www.healthynewbornnetwork.org\/resource\/institutionalizing-the-management-of-sick-young-infants-kenyas-experience-in-revising-national-guidelines-on-integrated-management-of-newborn-and-childhood-illnesses\/\">Institutionalizing the Management of Sick Young Infants: Kenya\u2019s Experience in Revising National Guidelines on Integrated Management of Newborn and Childhood Illnesses<\/a><\/li>\r\n<\/ul>\r\n[\/vc_column_text][\/vc_column][vc_column][\/vc_column][\/vc_row]","post_title":"Treatment of possible severe bacterial infection (PSBI)","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"treatment-of-possible-severe-bacterial-infection","to_ping":"","pinged":"","post_modified":"2023-11-13 11:49:50","post_modified_gmt":"2023-11-13 16:49:50","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=issue&p=411","menu_order":0,"post_type":"issue","post_mime_type":"","comment_count":"0","filter":"raw"}],"regions":[{"ID":251,"post_author":"7211","post_date":"2015-11-22 21:37:22","post_date_gmt":"2015-11-22 21:37:22","post_content":"","post_title":"Asia","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"asia","to_ping":"","pinged":"","post_modified":"2016-02-11 21:51:07","post_modified_gmt":"2016-02-11 21:51:07","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=region&p=251","menu_order":0,"post_type":"region","post_mime_type":"","comment_count":"0","filter":"raw"}],"countries":[{"ID":184,"post_author":"7211","post_date":"2015-10-21 21:58:21","post_date_gmt":"2015-10-21 21:58:21","post_content":"[vc_row][vc_column css=\".vc_custom_1453305596740{padding-top: 30px !important;padding-bottom: 30px !important;}\"][vc_text_separator title=\"Leading causes of neonatal deaths in India (2020)\" el_class=\"transform:upperclass\"][vc_row_inner][vc_column_inner][vc_round_chart type=\"doughnut\" stroke_width=\"1\" stroke_color=\"custom\" values=\"%5B%7B%22title%22%3A%221%25%20Diarrhoea%22%2C%22value%22%3A%221%25%22%2C%22color%22%3A%22vista-blue%22%7D%2C%7B%22title%22%3A%220%25%20Tetanus%22%2C%22value%22%3A%220%25%22%2C%22color%22%3A%22mulled-wine%22%2C%22custom_color%22%3A%22%23cec2ab%22%7D%2C%7B%22title%22%3A%227%25%20Pneumonia%22%2C%22value%22%3A%227%25%22%2C%22color%22%3A%22peacoc%22%7D%2C%7B%22title%22%3A%2239%25%20Preterm%20birth%20complications%22%2C%22value%22%3A%2239%25%22%2C%22color%22%3A%22blue%22%7D%2C%7B%22title%22%3A%2221%25%20Intrapartum%20related%20events%22%2C%22value%22%3A%2221%25%22%2C%22color%22%3A%22turquoise%22%7D%2C%7B%22title%22%3A%225%25%20Sepsis%20and%20other%20infectious%20conditions%20of%20the%20newborn%22%2C%22value%22%3A%225%25%22%2C%22color%22%3A%22pink%22%7D%2C%7B%22title%22%3A%229%25%20Congenital%20abnormalities%5Ct%22%2C%22value%22%3A%229%25%22%2C%22color%22%3A%22violet%22%7D%2C%7B%22title%22%3A%2218%25%20Other%20conditions%22%2C%22value%22%3A%2218%25%22%2C%22color%22%3A%22chino%22%7D%5D\" custom_stroke_color=\"#f6f6f4\" css=\".vc_custom_1686158564827{padding-right: 30px !important;padding-left: 30px !important;background-position: center !important;background-repeat: no-repeat !important;background-size: contain !important;}\"][\/vc_column_inner][\/vc_row_inner][vc_column_text]\r\n<h6 style=\"text-align: left;\">Source: Estimates for causes of death 2000-2020 generated by the WHO and Maternal and Child Epidemiology Estimation Group (MCEE) 2023 and downloaded from <a href=\"http:\/\/data.unicef.org\/\" target=\"_blank\" rel=\"noopener noreferrer\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=http:\/\/data.unicef.org&source=gmail&ust=1551964625737000&usg=AFQjCNFsFTtu9FzS8H64YC88NPOzQVbPwQ\">http:\/\/data.unicef.org<\/a><\/h6>\r\n[\/vc_column_text][\/vc_column][\/vc_row][vc_row full_width=\"stretch_row\" gap=\"5\" css=\".vc_custom_1453306441839{background-image: url(\/\/www.healthynewbornnetwork.org\/hnn-content\/uploads\/country-stat-bkgr.jpg?id=389) !important;background-position: center !important;background-repeat: no-repeat !important;background-size: cover !important;}\"][vc_column css=\".vc_custom_1453306493120{margin-top: 30px !important;margin-bottom: 30px !important;}\"][vc_text_separator title=\"key indicators\" el_class=\"transform:uppercase text-white\"][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158668744{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">19.1<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Newborn mortality rate (deaths per 1,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158653873{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">4<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Annual reduction in newborn mortality rate 2000-2021 (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158622111{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">62<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Proportion of under-5 child deaths that are newborn (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158639136{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">12.2<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Stillbirth rate (deaths per 1,000 births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_row_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158578078{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">89.4\r\n<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Skilled birth attendance (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1651070613999{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #41aaab;\"><strong><span class=\"ticker\">57<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Early initiation of breastfeeding (%)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1698696298715{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #e05533;\"><strong><span class=\"ticker\">13<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Preterm birth rate (births <37 weeks per 100 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][vc_column_inner width=\"1\/4\"][vc_column_text css=\".vc_custom_1686158608753{margin-bottom: -5px !important;}\"]\r\n<h1 style=\"text-align: center;\"><span style=\"color: #d9a23b;\"><strong><span class=\"ticker\">103<\/span><\/strong><\/span><\/h1>\r\n[\/vc_column_text][vc_column_text el_class=\"text-white\"]\r\n<h5 style=\"text-align: center;\">Maternal mortality ratio (deaths per 100,000 live births)<\/h5>\r\n[\/vc_column_text][\/vc_column_inner][\/vc_row_inner][vc_column_text css=\".vc_custom_1453307990481{margin-top: 20px !important;}\"]\r\n<h5 style=\"text-align: center;\"><span style=\"color: #ffffff;\">Visit our<\/span> <a href=\"https:\/\/www.healthynewbornnetwork.org\/numbers\/\">Newborn Numbers<\/a> <span style=\"color: #ffffff;\">page to explore the most recent data further<\/span><\/h5>\r\n[\/vc_column_text][\/vc_column][\/vc_row]","post_title":"India","post_excerpt":"","post_status":"publish","comment_status":"closed","ping_status":"closed","post_password":"","post_name":"india","to_ping":"","pinged":"","post_modified":"2023-10-30 16:03:36","post_modified_gmt":"2023-10-30 20:03:36","post_content_filtered":"","post_parent":0,"guid":"http:\/\/www.healthynewbornnetwork.org\/?post_type=country&p=184","menu_order":0,"post_type":"country","post_mime_type":"","comment_count":"0","filter":"raw"}],"views":"918"},"_links":{"self":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/46214"}],"collection":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource"}],"about":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/types\/resource"}],"author":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/users\/7211"}],"replies":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/comments?post=46214"}],"version-history":[{"count":0,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/resource\/46214\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media\/46216"}],"wp:attachment":[{"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/media?parent=46214"}],"wp:term":[{"taxonomy":"toolkit","embeddable":true,"href":"https:\/\/www.healthynewbornnetwork.org\/wp-json\/wp\/v2\/toolkit?post=46214"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}