Neonatal Care in Samoa, Fatupaito
Download
Report
Transcript Neonatal Care in Samoa, Fatupaito
Dr. Farah Fatupaito
PRSH Conference
Samoa 2013
2
main- Upolu
1 main Savaii
8 district hospitals
Experienced Midwives in each
hospital
All sick newborns referred to
Tupua Tamasese Meaole Hospital
neonatal health issues
Mortality rates
Progress to achieving MDGs of reducing child
mortality
Strategies to achieving MDG 4
Challenges and opportunities to improve
services
Respiratory
tract infections
Acute gastroenteritis
Low birth weight babies and
congenital abnormalities
Malnutrition
Rheumatic fever
Iron deficiency anemia
Breast feeding
Immunization coverage
1
Pneumonia
2
3
Acute bronchiolitis
Acute gastroenteritis
4
5
Typhoid fevers
Infections of the skin/ subcutaneous
tissues
Injuries , wounds , fractures , poisoning
Aspiration syndromes ( meconium )
Bacterial sepsis of the newborn
prematurity / Low birth rates
Asphyxia / fetal distress
6
7
8
9
10
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
total number of admissions to
NNU
1200
1000
800
600
number
400
200
0
2009
2010
2011
2013
Admission by disease to NNU (%) 2011
low bwt
22%
csect
42%
home del
3%
MSAF
11%
MAS
twins
3%
cong abn
2%
big babies
8%
asphyxia
4%
5%
admission to NNU by disease (%)2012
Abnormal Babies Home
delivery Twins
2%
2%
3%
Big babies
8%
LBW
17%
C-Section
45%
MSAF
Asphyxia
6%
13%
Meconium
aspiration
4%
total number of low birth weight babies per
year
180
171
160
150
140
137
128
120
100
80
60
40
20
0
2009
2010
2011
2012
low birth weight over 4 years
140
t
120
o
t 100
a
l
80
LBW
VLBW
n
u
ELBW
60
m
b
40
e
r
20
0
2009
2010
2011
2012
Conditions
RESUSCITATION
FLUID AND ELECTROLYTE mx
Prevention and treatment
of INFECTION
Long stays in NNU
250
200
150
MAS
100
MSAF
50
0
20092010
20112012
Rates
2009- 5%
2010- 6.8%
2011- 3%
2013-4%
Years
Neonatal Post
Infant
Child
Under
precedin mortality neonatal mortality mortality five
g SDHS
mortality
mortality
0-4
5
5
9
6
15
5-9
6
3
9
4
13
1014
5
3
8
4
12
Source :Samoa Demographic
Survey
Years
Neonatal
preceding mortality
SDHS
Post
neonatal
mortality
Infant
mortality
Child
mortality
Under
five
mortality
0-4
5
5
9
6
15
5-9
6
3
9
4
13
1014
5
3
8
4
12
Source :Samoa Demographic
Survey
Samoa
Tonga
Fiji
Tuvalu
Kiribati
PNG
Solomon Is
micronesia
8
8
8
14
19
23
11
17
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
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
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
Prematurity and
complications
Meconium
Big babies
Congenital
abnormalities
Home deliveries
Staff turnovers
Need for
specialisation in
neonatal nursing
Early referrals from
TBA
Continuous trainingNewborn resus/care
Better antenatal care
Equipments for new
hosp?
research