EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING

More documents

Recommendations

Info

Specific issues identified Provider issues: There is limited/updated knowledge on management of neonatal sepsis (assessment, dosage) among in-‐service health workers. This leads to insufficient use of antibiotics for neonatal sepsis indications, fear of ototoxicity due to overdose of gentamycin and fear of overuse of Ceftriaxone Formulation/ market shaping: Innovative delivery systems (pre-‐filled, single-‐use syringe, auto-‐disable, small syringes, safe retractable syringes, intravenous line) for gentamicin is technically feasible but there are regulatory barriers and are recommended. Ceftriaxone has an excellent safety profile and efficacy when used once daily but available packaging is not cost effective and associated with wastage and increased chances of loss of potency when one vial is mixed and not completely used under poor storage conditions Evidence/ regulatory issues: The national standards for newborn health recommend use of ampicillin instead of procaine penicillin yet WHO does not recommend ampicillin for neonatal sepsis treatment. Gentamycin toxicity (primarily hearing damage) when overdosed in neonates and greater risk in preterm and asphyxiated babies. Awareness/ demand Implementation plan The priority actions are linked to promoting the correct use of available products.: a) Immediate plan • Add an addendum on EML and treatment guidelines to include gentamicin and ceftriaxone for neonatal sepsis management (in appropriate packaging and strengths with accompanying supplies) at all health facility levels as appropriate i.e. pre-‐referral gentamicin at HC II plus Ceftriaxone at HC III to Hospital level). Hold stakeholder meetings to reach consensus on EML review and develop respective addendums. • Conduct refresher training for in-‐service health workers and integrate latest updates in neonatal sepsis management in pre-‐service curricula for all health workers cadres. b) Intermediate plan • Also review and disseminate protocols on management of neonatal sepsis and administration of antibiotics to neonates and establish TWGs and convene meetings/workshops to review protocols and job aids and review of training packages.
• Dissemination of revised protocols and job aids 3.3.3 Newborn Resuscitation Devices Problem statement Intra-‐partum related complications including birth asphyxia the failure of the newborn to establish breathing after birth, kills 10,920 newborns every year, accounting for over a quarter of newborn deaths in Uganda. Proper neonatal resuscitation including bag and mask and suction devices could easily prevent the majority of these deaths. Although quality affordable devices that are meeting international standards are available, the specifications and standardization of such devices are rarely regulated at national level and product selection guidance is not universally available to national-‐level procurement leads. Further, the devices themselves are infrequently available and used at every location where deliveries occur. As a medical device, this commodity faces additional supply challenges, including irregular procurement and sterilization, compared to the other 12 focus commodities of the Commission. Additionally, in order to maintain provider skills and ability to manage birth asphyxia, birth attendants require quality practical pre-‐ and in-‐service training, with routine refresher trainings and on-‐site mentorships and support. Specific issues identified Provider issues: Limited health worker knowledge & skills and mechanisms for building and maintaining skills (including use and maintenance of the devices). As a result, birth attendants often incorrectly use devices. Quality: Inappropriate specifications of devices (in size, quantity and quality) leading to wrong procurement and distribution to centers where deliveries take place including HC IIs Implementation plan a) Immediate plan • Provide competency-‐based training and follow-‐up supportive supervision including all cadres in the health system. Convene meetings/workshops to review protocols and job aids and review of training at other levels). Conduct trainings of health workers on newborn resuscitation as a component of the integrated maternal and newborn care training package (HBB Plus) • Review pre and in-‐service training curricula to adequately address newborn resuscitation. b) Intermediate plan •
Page 2 and 3: 1. BACKGROUND ...................
Page 4 and 5: 1. BACKGROUND 1.1 Introduction The
Page 6 and 7: RMNCH services and commodities
Page 8 and 9: 1.3 Process of development of
Page 10 and 11: integrated. There will be an i
Page 12 and 13: Product development/ market shap
Page 15: community level. However the po
Page 22 and 23: A parallel step will be to im
Page 24 and 25: inefficiencies and sustainability
Page 26 and 27: 3.4.2 Amoxicillin tablets for tr
Page 28 and 29: progressively achieve national c
Page 30: REFERENCES 1. Annual Health Secto

EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING

Create successful ePaper yourself

Delete template?

Save as template?

EVERY WOMEN EVERY CHILD UN COMMISSION ON LIFE-âSAVING