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Reducing newborn mortality in the A sia– P acific region: Quality hospital services and community‐based care
Author(s) -
Milner Kate M,
Duke Trevor,
Bucens Ingrid
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12249
Subject(s) - medicine , referral , health care , neonatal mortality , family medicine , quality (philosophy) , infant mortality , nursing , pediatrics , gerontology , medical emergency , environmental health , population , philosophy , epistemology , economics , economic growth
Abstract Improving newborn health and survival is an essential part of progression toward Millennium Development Goal 4 in the W orld H ealth O rganization W estern P acific and S outh E ast A sian regions. Both community and facility‐based services are required. Strategies to improve the quality of care provided for newborns in health clinics and district‐ and referral‐level hospitals have been relatively neglected in most countries in the region and in the published literature. Indirect historical evidence suggests that improving facility‐based care will be an increasing priority for improving newborn survival in A sia and the Pacific as newborn mortality rates decrease and health systems contexts change. There are deficiencies in many aspects of newborn care, including immediate care and care for seriously ill newborns, which contribute substantially to regional newborn morbidity and mortality. We propose a practical quality improvement approach, based on models and standards of newborn care for primary‐, district‐ and referral‐level heath facilities and incorporated within existing maternal, newborn and child health programmes. There are examples where such approaches are being used effectively. There is a need to produce more nurses, community health workers and doctors with skills in care of the well and the sick newborn, and there are W orld H ealth O rganization models of training to support this, including guidelines on emergency obstetric and newborn care and the P ocket B ook of H ospital C are for C hildren . There are also simple data collection and analysis programmes that can assist in auditing outcomes, problem identification and health services planning. Finally, with increased survival rates there are gaps in follow‐up care for newborns at high risk of long‐term health and developmental impairments, and addressing this will be necessary to ensure optimal developmental and health outcomes for these children.