The COVID-19 outbreak is affecting the quality of care given to new and sick babies in all parts of the world and threatening the implementation of life-saving interventions, new research suggests was published there BMJ Global Health.
The study is the first published study targeting new and sick babies during the pandemic. It was produced by a global collaboration, enabled by the London School of Hygiene & Tropical Medicine (LSHTM) St. John’s College of Medicine, Bangalore, India and NEST360.
Through an online questionnaire, the research team surveyed thousands of neonatal health care providers from 62 countries around the world, collecting data on the impact of pandemic disease on neonatal care. The largest numbers of respondents were in Africa and Asia (> 76%).
Over 85% of survey respondents said they were ‘afraid of their own health’, with PPE deficiency, stress and safety concerns among the issues reported. In some hospitals, they described critical facilities including staffing and equipment, particularly oxygen supply, moving them from neonatal wards to COVID-19 care wards.
A crucial finding was that two-thirds of health workers would not support Kangaroo Mother Care (KMC), a life-saving approach involving early, long skin-to-skin contact for babies premature and exclusive breastfeeding, for mothers with a positive effect or unknown COVID-19 test status. Instead, these newborns are separated from their mothers and are at greater risk of death.
The importance of this finding is confirmed by new research published in EClinicalMedicine. Carried out by a global collaboration led by the World Health Organization with LSHTM and the University of California San Francisco (UCSF), which conducted analyzes for 127 countries, the study estimated whether universal coverage of achieving KMC, more than 125,000 newborn lives would have been saved. On the other hand, the risk of newborns catching COVID and dying would lead to less than 2,000 deaths. Taken together, this indicates at least a 65-fold increase in risk of death by not performing KMC.
Kangaroo Maternal Care is one of the most cost effective ways to protect new and sick babies. Now it is more critical than ever to ensure that mothers are supported to perform KMC and that health care professionals feel safe and comfortable receiving support in delivery. Our data show great promise for much of the lives saved by universal KMC, so it is vital that we use this opportunity to strengthen care now and build better after the pandemic. “
Suman PN Rao, Principal study author and Professor, St. John’s College of Medicine
Newborns are the most vulnerable citizens in the world. Each year 2.5 million newborns die within 28 days of a birthday, over 80% of which are with low birth weight. Despite this, new and sick babies have not been considered in global assessments of pandemic-related effects.
1,120 participants responded to the study, designed by a multidisciplinary team. Healthcare workers reported higher than normal weight levels with 85% fearing for their own health. Over 70% of respondents said there was a shortage of high-quality eye shields and face masks and less than a fifth of healthcare providers felt confident about guidelines for treating maternal newborns infectious COVID-19.
The lack of a SARS-CoV-2 test was identified as a major challenge by many respondents. Only one-third of respondents said that tests were routinely available for pregnant women who had been admitted for delivery (36.2%), and those with symptoms or a history of contact (30.7%). ). It was reported that 21.9% of respondents from Africa did not have tests of pregnant women for admission.
Dr Queen Dube, co-author, Pediatrician and Director of Health Services, Malawi, said:
“COVID-19 has had a terrible hole in our small and sick children across Africa. In Malawi we have seen this on the front line – workers with pressure and oxygen transfer equipment to other areas managing COVID-19 patients It is heartbreaking but we can do more to protect mothers and babies.We are seeing new innovations every day.With wise engineering and energetic conversion, it was possible for NEST360 in Malawi to develop and produce PPE.This is the time to use learning to strengthen health systems and significantly improve care for 15 million new premature babies worldwide each year. “
There has been a reduction in hospital births and neonatal admissions in all areas as well as neonatal care due to women for fear of hospital admission, redistribution of personnel and / or equipment from neonatal units. Those admitted to hospital for birth and neonatal care were more likely to want early discharge and not to seek neonatal follow-up care. Reports of redistribution of oxygen supply from newborns and delays in the treatment of infants until COVID-19 production is obtained are of great concern.
Further research is needed, examining how to enable healthcare workers to perform, in particular addressing the fear of contact with patients with undiagnosed disease (inappropriate testing equipment), and equipment inadequate protection (foreign faces and shields).
Prevention of infection in practice is also important. Guidance for neonatal care in the pandemic may be lacking, unknown, unclear or potentially incorrect. Urgent research is needed into mitigation strategies to promote the mental health and well-being of frontline health care workers, as well as how to protect women and their newborns.
Professor Joy Lawn from LSHTM, as well as NEST360, and senior author of both papers, said:
“Our findings show how COVID-19 disrupts care for small and sick babies around the world. Newborns can die in minutes and are more vulnerable, even more vulnerable. greater in pandemic.
Policy makers can and must protect neonatal health services, ensuring evidence-based practices for all, including SARS-CoV-2-positive women. Healthcare workers around the world are doing an outstanding job despite challenging conditions, and vaccines are urgently needed to protect them. Fast implementation data and monitoring must be part of a driving activity. We will see reversals for hard benefits in newborn survival if we don’t take action now. “
Source:
London School of Hygiene & Tropical Medicine