Paediatrics and international child health
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Paediatr Int Child Health · Aug 2015
ReviewNeonatal surgical care: a review of the burden, progress and challenges in sub-Saharan Africa.
The outcome of neonatal surgery has significantly improved over the decades in high-income countries. In sub-Saharan Africa (SSA), however, it has lagged behind. This is a review of the current state of neonatal surgery in SSA. ⋯ While the number of paediatric surgeons has increased, there are still few anaesthetists. In order to significantly improve the outcome for neonates with surgical problems in SSA, paediatric surgery, anaesthesia, neonatology and neonatal nursing capacity need to be scaled up and fast-tracked. To make neonatal surgery safer in these settings, neonatal intensive care facilities need to be provided and improved.
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Paediatr Int Child Health · Aug 2015
ReviewState of neonatal health care in eight countries of the SAARC region, South Asia: how can we make a difference?
The South Asian Association for Regional Cooperation (SAARC) is an organization of eight countries--Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, Sri Lanka and Afghanistan. The major objectives of this review are to examine trends and progress in newborn and neonatal health care in the region. A landscape analysis of the current state of neonatal mortality, stillbirths and trends over the years for each country and the effective interventions to reduce neonatal mortality and stillbirths was undertaken. ⋯ The major causes of neonatal mortality are intrapartum-related deaths, preterm birth complications and sepsis which account for nearly 80% of all deaths. The LiST analysis shows that a gradual increase in coverage of proven available interventions until 2020 followed by a uniform scale-up to 90% of all interventions until 2030 could avert 52% of neonatal deaths (0.71 million), 29% of stillbirths (0.31 million) and achieve a 31% reduction in maternal deaths (0.25 million). The analysis demonstrates that the Maldives and Sri Lanka have done remarkably well while other countries need greater attention and specific focus on strategies to improve neonatal health.
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Paediatr Int Child Health · Aug 2015
ReviewConfronting stillbirths and newborn deaths in areas of conflict and political instability: a neglected global imperative.
Despite considerable improvements in reproductive and newborn health throughout the world, relatively poor outcomes persist in areas plagued by conflict or political instability. ⋯ Despite troubling relative and absolute indicators, the special requirements of improving reproductive and neonatal outcomes in areas affected by conflict and political instability have not received adequate attention. New integrated political and technical strategies will be required. This should include moving beyond traditional approaches concerned with complex humanitarian emergencies. Rather, global efforts must be based on a deeper understanding of the specific governance requirements associated with protracted and widespread health requirements. A focus on women's roles, regional strategies which take advantage of relative stability and governance capacity in neighbouring states, virtual infrastructure, and assistance regimens directed specifically to unstable areas may prove useful.