dc.date.accessioned | 2023-01-31T17:42:39Z | |
dc.date.available | 2023-01-31T17:42:39Z | |
dc.date.created | 2022-08-03T08:49:20Z | |
dc.date.issued | 2022 | |
dc.identifier.citation | Heen, Espen Kolstad Størdal, Ketil Abdi, Abdirashid Walmann, Frøydis Lundeby, Karen Marie . Facility-based care of small and sick newborns: experiences with establishing a neonatal special care unit in Somaliland. Journal of Global Health Reports (JoGHR). 2022, 6 | |
dc.identifier.uri | http://hdl.handle.net/10852/99477 | |
dc.description.abstract | Background
The goal of the United Nations is a global neonatal mortality rate (NMR) lower than 12/1000 by 2030. In stark contrast, facility-based care of small and sick newborns is limited and substandard in many low-income countries (LIC). There is a need to identify broad packages of high-quality and low-cost, sustainable interventions suitable for scale-up in fragile states and high burden countries. This article describes the process, output, and experience of establishing a neonatal special care unit (NSCU) at a governmental hospital in Somaliland.
Methods
We collected data from administrative documents, staff experiences, patient registries, and primary caretaker interviews covering 164 admissions through 5 months and systematized the findings within the 6 building blocks of the health care system (WHO).
Results
Running an NSCU in a Somali context is both possible and feasible when implementers are willing to bridge gaps on all health systems building blocks simultaneously. A verified NSCU survival rate of 85% within the first year was achieved - in line with reputable neonatal wards in the wider Eastern Africa. General caretaker satisfaction was rated as “good.” Major challenges were lack of a national regulatory framework, including an effective funding allocation; staff unfamiliarity with detailed guidelines, protocols, and job descriptions; and poor availability of medicines and other neonatal disposables. For less than US$175 in running cost per patient, including staff salaries and major equipment replacements, 75% of small and sick newborns received admission-to-discharge curative care. Public demand for facility-based newborn care was quickly growing during the implementation phase. Neonatal nurses quickly drift to nongovernmental and urban employers without a persistent and deliberate overcapacity in training courses and a strong public retention policy. A 100% service coverage in Somaliland will require dedicated wards (NSCU) with equipment at all hospitals with a labor ward, and training and deployment of about 400 neonatal nurses.
Conclusions
The described package of interventions may have the potential for further scale-up to district hospitals in Somaliland. Policymakers and hospital administrators should strive for a stronger national regulatory, administrative, and technical framework in neonatal curative care, facilitating the simultaneous development of all of WHO’s 6 health systems building blocks. We expect many of the findings to be transferable to the wider Somalia and other fragile LIC. | |
dc.language | EN | |
dc.publisher | International Society of Global Health | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.title | Facility-based care of small and sick newborns: experiences with establishing a neonatal special care unit in Somaliland | |
dc.title.alternative | ENEngelskEnglishFacility-based care of small and sick newborns: experiences with establishing a neonatal special care unit in Somaliland | |
dc.type | Journal article | |
dc.creator.author | Heen, Espen Kolstad | |
dc.creator.author | Størdal, Ketil | |
dc.creator.author | Abdi, Abdirashid | |
dc.creator.author | Walmann, Frøydis | |
dc.creator.author | Lundeby, Karen Marie | |
cristin.unitcode | 185,52,14,0 | |
cristin.unitname | Avdeling for samfunnsmedisin og global helse | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 1 | |
dc.identifier.cristin | 2040807 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal of Global Health Reports (JoGHR)&rft.volume=6&rft.spage=&rft.date=2022 | |
dc.identifier.jtitle | Journal of Global Health Reports (JoGHR) | |
dc.identifier.volume | 6 | |
dc.identifier.doi | https://doi.org/10.29392/001c.33619 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 2399-1623 | |
dc.type.version | PublishedVersion | |
cristin.articleid | e2022015 | |