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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
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
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
slide9

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
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
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

slide31

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
ad