Challenges in neonatal care in samoa
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Challenges in neonatal care in Samoa. Dr. Farah Fatupaito PRSH Conference Samoa 2013. Hospitals in Samoa. 2 main- Upolu 1 main Savaii 8 district hospitals Experienced Midwives in each hospital All sick newborns referred to Tupua Tamasese Meaole Hospital. Faafetai. outline.

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Challenges in neonatal care in samoa

Challenges in neonatal care in Samoa

Dr. Farah Fatupaito

PRSH Conference

Samoa 2013


Hospitals in samoa

Hospitals in Samoa

  • 2 main- Upolu

  • 1 main Savaii

  • 8 district hospitals

  • Experienced Midwives in each hospital

  • All sick newborns referred to TupuaTamaseseMeaole Hospital


Faafetai

Faafetai


Outline

outline

  • neonatal health issues

  • Mortality rates

  • Progress to achieving MDGs of reducing child mortality

  • Strategies to achieving MDG 4

  • Challenges and opportunities to improve services


Priority child health issues in samoa

Priority child health issues in Samoa


Key issues in child health

Key issues in child health

  • Respiratory tract infections

  • Acute gastroenteritis

  • Low birth weight babies and congenital abnormalities

  • Malnutrition

  • Rheumatic fever

  • Iron deficiency anemia

  • Breast feeding

  • Immunization coverage


10 leading causes of hospital morbidity 0 13 years fy 07 08

10 leading causes of hospital morbidity 0-13 years FY 07/08


Challenges in neonatal care in samoa

Total number of admissions to NNU

  • 2009 -823

  • 2010 - 911

  • 2011 - 806

  • 2013 -1020

Number of deliveries at TTM

  • 2009-3490

  • 2010-3057

  • 2011-3972

  • 2012-4012


Challenges in neonatal care in samoa

Conditions


Management of complications

MANAGEMENT of complications

  • RESUSCITATION

  • FLUID AND ELECTROLYTE mx

  • Prevention and treatment

    of INFECTION

  • Long stays in NNU


Meconium stained liguor

Meconium stained liguor

Rates

  • 2009- 5%

  • 2010- 6.8%

  • 2011- 3%

  • 2013-4%


Infant and childhood mortality rates

Infant and childhood mortality rates

Source :Samoa Demographic Survey


Infant and childhood mortality rates1

Infant and childhood mortality rates

Source :Samoa Demographic Survey


Neonatal mortality rates 2011

Neonatal mortality Rates 2011

  • 8

  • 8

  • 8

  • 14

  • 19

  • 23

  • 11

  • 17

  • Samoa

  • Tonga

  • Fiji

  • Tuvalu

  • Kiribati

  • PNG

  • Solomon Is

  • micronesia


Mdgs at a glance for samoa

MDGs at a glance for Samoa


G oal 4 reduce child mortality

Goal 4: Reduce child mortality

TARGET

Reduce child mortality by 2/3 between 1990 and 2015

INDICATORS

Under five mortality rates

Infant mortality rates

Proportion of 1 year old children immunised against measles


Strategies that work

Strategies that work


Challenges in neonatal care in samoa

Seven essential service

Package for child survival

  • Skilled attendance during pregnancy,

  • delivery and immediate postpartum

  • Care of the newborn

  • Breastfeeding and complementary

  • feeding

  • Micronutrient supplementation

  • Immunization of children and mothers

  • Integrated management of sick children

4


Innovations to improve outcome

Innovations to improve outcome

  • Bubble CPAP 2009- improve survival rates in LBW

  • POINTS training for nurses 2012-2013

  • Protocols

  • Visiting Neonatologist Specialists

  • Medicines eg. surfactant, probiotics,

  • Newborn screening tests

  • Annual neonatal resuscitation courses


Ongoing challenges

Ongoing challenges

  • Staff turnovers

  • Need for specialisation in neonatal nursing

  • Early referrals from TBA

  • Continuous training-Newborn resus/care

  • Better antenatal care

  • Equipments for new hosp?

  • research

  • Prematurity and complications

  • Meconium

  • Big babies

  • Congenital abnormalities

  • Home deliveries


What would this world be without children

What would this world be without children ?


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