RESUMO
AIM: Building strategies for the country-level dissemination of Kangaroo mother care (KMC) to reduce the mortality rate in preterm and low birth weight babies and improve quality of life. KMC is an evidence-based healthcare method for these infants. However, KMC implementation at the global level remains low. METHODS: The international network in Kangaroo mother brought 172 KMC professionals from 33 countries together for a 2-day workshop held in conjunction with the XIIth International KMC Conference in Bogota, Colombia, in November 2018. Participants worked in clusters to formulate strategies for country-level dissemination and scale-up according to seven pre-established objectives. RESULTS: The minimum set of indicators for KMC scale-up proposed by the internationally diverse groups is presented. The strategies for KMC integration and implementation at the country level, as well as the approaches for convincing healthcare providers of the safety of KMC transportation, are also described. Finally, the main aspects concerning KMC follow-up and KMC for term infants are presented. CONCLUSION: In this collaborative meeting, participants from low-, middle- and high-income countries combined their knowledge and experience to identify the best strategies to implement KMC at a countrywide scale.
Assuntos
Método Canguru , Criança , Colômbia , Feminino , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido de Baixo Peso , Recém-Nascido , Qualidade de VidaRESUMO
The continued occurrence of congenital syphilis is an indictment of the inadequate antenatal care services and poor quality of programmes to control sexually transmitted infections...
Assuntos
Feminino , Humanos , Cuidado Pré-Natal , Sífilis Congênita , Testes Sorológicos , Fatores de RiscoRESUMO
OBJECTIVE: To report stillbirth and early neonatal mortality and to quantify the relative importance of different primary obstetric causes of perinatal mortality in 171 perinatal deaths from 7993 pregnancies that ended after 28 weeks in nulliparous women. METHODS: A review of all stillbirths and early newborn deaths reported in the WHO calcium supplementation trial for the prevention of pre-eclampsia conducted at seven WHO collaborating centres in Argentina, Egypt, India, Peru, South Africa and Viet Nam. We used the Baird-Pattinson system to assign primary obstetric causes of death and classified causes of early neonatal death using the International classification of diseases and related health problems, Tenth revision (ICD-10). FINDINGS: Stillbirth rate was 12.5 per 1000 births and early neonatal mortality rate was 9.0 per 1000 live births. Spontaneous preterm delivery and hypertensive disorders were the most common obstetric events leading to perinatal deaths (28.7% and 23.6%, respectively). Prematurity was the main cause of early neonatal deaths (62%). CONCLUSIONS: Advancements in the care of premature infants and prevention of spontaneous preterm labour and hypertensive disorders of pregnancy could lead to a substantial decrease in perinatal mortality in hospital settings in developing countries.
Assuntos
Países em Desenvolvimento/estatística & dados numéricos , Mortalidade Infantil , Natimorto/epidemiologia , Argentina/epidemiologia , Cálcio da Dieta/administração & dosagem , Causas de Morte , Suplementos Nutricionais , Egito/epidemiologia , Feminino , Humanos , Índia/epidemiologia , Recém-Nascido , Estudos Multicêntricos como Assunto , Peru/epidemiologia , Pré-Eclâmpsia/mortalidade , Pré-Eclâmpsia/prevenção & controle , Gravidez , Nascimento Prematuro/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , África do Sul/epidemiologia , Vietnã/epidemiologiaRESUMO
OBJECTIVE: Our objective with this article was to describe the declining trend in neonatal mortality in Chile between 1990 and 2000 and examine potential causal factors. METHODS: Descriptive analysis of data that were provided by the Chilean Ministry of Health on all approximately 2,900,000 births occurred in Chile between 1990 and 2000. Total neonatal mortality rates (<28 days), and birth weight-specific and gestational age-specific mortality rates from 1990 to 2000 were analyzed by year. Public health interventions that were implemented during the 1990s were reviewed to assess their potential influence on the observed trends in neonatal mortality. RESULTS: The neonatal mortality rate between 1990 and 2000 decreased from 8.3 to 5.7 per 1000 live births. This decline was not associated with decreases in the proportion of low birth weight and preterm infants but rather with declines in birth weight-specific and gestational age-specific mortality rates. Examination of the trends in birth weight-specific and gestational age-specific mortality rates showed that a marked proportional decrease in mortality rates was achieved among infants who weighed <1500 g and were delivered before 32 weeks. It is plausible, both biologically and temporally, that the observed trends in the reduction in birth weight-specific and gestational age-specific mortality rates are associated with the introduction of specific sector-wide interventions that aim to improve newborn care in very preterm and low birth weight infants. CONCLUSIONS: Important reductions in newborn mortality in developing countries are possible with the implementation of effective neonatal care interventions.