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Challenges in neonatal care in Samoa

Challenges in neonatal care in Samoa. Dr. Farah Fatupaito PRSH Conference Samoa 2013. Hospitals in Samoa. 2 main- Upolu 1 main Savaii 8 district hospitals Experienced Midwives in each hospital All sick newborns referred to Tupua Tamasese Meaole Hospital. Faafetai. outline.

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Challenges in neonatal care in Samoa

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  1. Challenges in neonatal care in Samoa Dr. Farah Fatupaito PRSH Conference Samoa 2013

  2. Hospitals in Samoa • 2 main- Upolu • 1 main Savaii • 8 district hospitals • Experienced Midwives in each hospital • All sick newborns referred to TupuaTamaseseMeaole Hospital

  3. Faafetai

  4. outline • neonatal health issues • Mortality rates • Progress to achieving MDGs of reducing child mortality • Strategies to achieving MDG 4 • Challenges and opportunities to improve services

  5. Priority child health issues in Samoa

  6. Key issues in child health • Respiratory tract infections • Acute gastroenteritis • Low birth weight babies and congenital abnormalities • Malnutrition • Rheumatic fever • Iron deficiency anemia • Breast feeding • Immunization coverage

  7. 10 leading causes of hospital morbidity 0-13 years FY 07/08

  8. 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

  9. Conditions

  10. MANAGEMENT of complications • RESUSCITATION • FLUID AND ELECTROLYTE mx • Prevention and treatment of INFECTION • Long stays in NNU

  11. Meconium stained liguor Rates • 2009- 5% • 2010- 6.8% • 2011- 3% • 2013-4%

  12. Infant and childhood mortality rates Source :Samoa Demographic Survey

  13. Infant and childhood mortality rates Source :Samoa Demographic Survey

  14. Neonatal mortality Rates 2011 • 8 • 8 • 8 • 14 • 19 • 23 • 11 • 17 • Samoa • Tonga • Fiji • Tuvalu • Kiribati • PNG • Solomon Is • micronesia

  15. MDGs at a glance for Samoa

  16. Goal 4: Reduce child mortality 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

  17. Strategies that work

  18. 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

  19. Innovations to improve outcome • 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

  20. Ongoing challenges • Staff turnovers • Need for specialisation in neonatal nursing • Early referrals from TBA • Continuous training-Newborn resus/care • Better antenatal care • Equipments for new hosp? • research • Prematurity and complications • Meconium • Big babies • Congenital abnormalities • Home deliveries

  21. What would this world be without children ?

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