Upload
others
View
3
Download
0
Embed Size (px)
Citation preview
1
Care for the Small & Sick Newborn Community of Practice Webinar
Implementation lessons from improving care for small and sick newborns in health facilities
David GatharaAssistant Professor of Health Systems
NEST360 Health Systems LeadLondon School of Hygiene and Tropical Medicine
National partnership for SSNC in Kenya
• Ministry of Health leadership – Division of Neonatal and Child health
• NEST network linkage with academic and professional institutions
• Network of hospitals
• National Newborn Committee of Experts convened• Validation of newborn protocols, aligned to WHO Standards
• Oversight of pre-service and in-service training
• Continuing Medical Education through webinars – multi-disciplinary team
• Joint operationalisation of regular hospital QI visits
NEST360 Overview – What are we doing?
NEST Bundle of Technologies
1. Radiant warmer2. Suction machine3. Oxygen concentrator4. Pulse oximeter
5. CPAP6. Oxygen splitter 7. Phototherapy lights8. Glucometer + strips
+ Maintenance kit
Health Systems Package
Implementation support:
• National policy change
• Data tools/systems, data use
• Investment case
Clinical & Technical:
• Pre-Service Education
• In-Service Education
• Supervision & Mentorship
Devices:
• Distribution and post
sales support
• Financing options
Rigorous “complex” evaluation of impact and cost
Implementation research with active learning and use of data
QI
Infrastructural improvements
• Multidisciplinary infrastructural improvement team input on model NBU blue-print layout
• Government County-led renovations supported by the NEST Kenya team
• Pre-implementation assessment with Go or No-Go yet criteria
Contextualising and consolidating learning
Adapted modules were presented to 118 people including;o Univ of Nairobi Paediatrics postgraduate studentso CIN focal persons (16 county hospitals, Nurses + paediatricians)o ETAT+ GIC instructorso Neonatal Nurseso Technical Working Group
Integrating NEST within national package for ETAT+
Delivering care with a constrained workforce –implications on quality and staff well-being
Nurses responsible for delivering most of the interventions in the newborn units
Nurse burnout
Adapting training approaches in pandemic
1. Pre-service training• Skills-lab
2. In-service training • Hands on training with
newborn devices
Practical-based training for clinical and bio-medical staff
Train bio-medical engineers on preventive and corrective maintenance
Threat… and an
opportunity
Implementation learning for Human Resources for Health
Opportunities
• Role of task-sharing/shifting
• Integrating technical training into clinical pre-service training
• Joint training of clinical with biomed technical staff – enhance
team work
• Evidence for optimal staffing ratios
• Investment case for MNH HR
AdmissionsDeaths
Care pathways
Health system inputs
Sustaining change • Facility level: Ongoing QI to
support/address challenges, linked to local data dashboards
• Multi facility networks: Learning collaborative highlighting successes and areas requiring improvement
• Community of practice for newborncare (neonatologists, paediatricians, nurses, biomedical engineers) via WhatsApp – sharing lessons
BEYOND SINGLE INTERVENTIONS and ‘ONE AT A TIME APPROACHES
Implementing quality care using a health systems approach –people centred, family centred care at the heart
8 Standards Collating practical resources, tools and active learning for
small & sick newborn care in low & middle income settings.
Addressing priority health system bottlenecks. eg floor plans,
data tools, device maintenance checklists
Human Resources- HSBB Group
23rd JUNE 2021 12.30 – 2 PM GMT !!!
Implementation Toolkit
for Small and Sick Newborn Care
WELCOME ALL!
Email: [email protected]@lshtm.ac.uk