Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos

Schmidt, Simone; Bounnack, S; Hoehn, Thomas

doi:10.1016/j.puhe.2017.10.021

Cited by 5 publications

(3 citation statements)

References 8 publications

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“…Nineteen studies described implementation of training programmes [ 63 , 86 , 128 , 130 , 139 , 141 , 157 , 181 , 184 - 195 ]. Thirteen of these described training programmes in neonatal resuscitation, specifically the Helping Babies Breathe programme (HBB).…”

Section: Resultsmentioning

confidence: 99%

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

et al. 2021

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Background Reducing preterm birth and stillbirth and improving outcomes for babies born too soon is essential to reduce under-5 mortality globally. In the context of a rapidly evolving evidence base and problems with extrapolating efficacy data from high- to low-income settings, an assessment of the evidence for maternal and newborn interventions specific to low- and middle-income countries (LMICs) is required. Methods A systematic review of the literature was done. We included all studies performed in LMICs since the Every Newborn Action Plan, between 2013 - 2018, which reported on interventions where the outcome assessed was reduction in preterm birth or stillbirth incidence and/or a reduction in preterm infant neonatal mortality. Evidence was categorised according to maternal or neonatal intervention groups and a narrative synthesis conducted. Results 179 studies (147 primary evidence studies and 32 systematic reviews) were identified in 82 LMICs. 81 studies reported on maternal interventions and 98 reported on neonatal interventions. Interventions in pregnant mothers which resulted in significant reductions in preterm birth and stillbirth were (i) multiple micronutrient supplementation and (ii) enhanced quality of antenatal care. Routine antenatal ultrasound in LMICs increased identification of fetal antenatal conditions but did not reduce stillbirth or preterm birth due to the absence of services to manage these diagnoses. Interventions in pre-term neonates which improved their survival included (i) feeding support including probiotics and (ii) thermal regulation. Improved provision of neonatal resuscitation did not improve pre-term mortality rates, highlighting the importance of post-resuscitation care. Community mobilisation, for example through community education packages, was found to be an effective way of delivering interventions. Conclusions Evidence supports the implementation of several low-cost interventions with the potential to deliver reductions in preterm birth and stillbirth and improve outcomes for preterm babies in LMICs. These, however, must be complemented by overall health systems strengthening to be effective. Quality improvement methodology and learning health systems approaches can provide important means of understanding and tackling implementation challenges within local contexts. Further pragmatic efficacy trials of interventions in LMICs are essential, particularly for interventions not previously tested in these contexts.

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Section: Resultsmentioning

confidence: 99%

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

et al. 2021

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“…9 This corresponds to the intention of our combined obstetric and pediatric teaching setting, although this may be difficult to quantify. 4 Since the origin of most neonatal conditions is already present or has its seeds in utero, it is obvious that obstetricians and neonatologists need to communicate very closely. The effectiveness of intensified communication has at least been shown for the delivery room setting.…”

Section: Discussionmentioning

confidence: 99%

“…To quantify the effect of the teaching, evaluations of the recorded neonatal mortality in the provincial hospitals took place before and after several episodes of teaching. 3,4 Teaching in the provincial hospitals was open to all professional groups looking after newborn infants (obstetricians, pediatricians, general practitioners, midwives, nurses, skilled birth attendants). We knowingly refrained from using the term neonatologist and rather used the term pediatrician since there is no neonatal curriculum established at the present time in Laos.…”

Section: Methodsmentioning

confidence: 99%

Immediate and Sustained Effect of Neonatal Teaching in a Perinatal Setting in Urban Laos

et al. 2019

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Objective This study aimed to quantify knowledge on neonatal topics among obstetricians and pediatricians participating in a perinatal teaching program aimed at reducing neonatal mortality in Laos. Study Design Obstetricians and pediatricians from Vientiane and the surrounding areas participated in a 1-week teaching program in obstetric and neonatal topics and responded to pre- and posttests questionnaires to quantify their knowledge. Results Although questions were predominantly related to neonatal topics, obstetricians performed significantly better than pediatricians during the pretest. Both groups increased their knowledge significantly as quantified by the results of the posttest. Conclusion The teaching program was effective in improving knowledge on perinatal mortality related topics of the participants. These results may be related to the fact that most of the obstetricians had participated in a structured teaching program previously, whereas the pediatricians did not. We thus speculate that there is a sustained effect of even a 1-week teaching program in neonatology even several years after the initial teaching.

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Establishment of a sustainable newborn TSH-screening program in the People's Democratic Republic of Laos

Vesaphong

Lindemuth

Istaz³

et al. 2021

Early Human Development

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Neonatal mortality and morbidity in the post-implementation period of a neonatal teaching program in provincial hospitals in Laos

Cited by 5 publications

References 8 publications

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

Immediate and Sustained Effect of Neonatal Teaching in a Perinatal Setting in Urban Laos

Establishment of a sustainable newborn TSH-screening program in the People's Democratic Republic of Laos

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