Background: Neonatal mortality comprises an increasing proportion of childhood deaths in the developing world. Essential newborn care practices as recommended by the WHO may improve neonatal outcomes in resource limited settings. Our objective was to pilot a Helping Babies Breathe and Essential Care for Every Baby (HBB and ECEB) implementation package using HBB-ECEB training combined with supportive supervision in rural Nicaragua.
Methods: We employed an HBB-ECEB implementation package in El Ayote and Santo Domingo, two rural municipalities in Nicaragua and used a pre- and post- data collection design for comparison. Following a period of pre-intervention data collection (June-August 2015), care providers were trained in HBB and ECEB using a train-the- trainer model. An external supportive supervisor monitored processes of care and collected data. Data on newborn care processes and short-term outcomes such as hypothermia were collected from facility medical records and analyzed using standard run charts. Home visits were used to determine breastfeeding rates at 7, 30 and 60 days.
Results: There were 480 institutional births during the study period (June 2015-June 2016). Following the HBB-ECEB implementation package, cord care improved (pre-intervention median 66%; post-intervention shift to ≥85%) and early skin-to-skin care improved (pre-intervention median 0%; post-intervention shift to ≥56%, with a high of 92% in June 2016). Rates of administration of ophthalmic ointment and vitamin K were high pre-intervention (median 97%) and remained high. Early initiation of breastfeeding increased with a pre-intervention median of 25% and post-intervention shift to ≥28%, with a peak of 81% in June 2016. Exclusive breastfeeding rates increased short-term but were not significantly different by 60-days of life (9% pre-intervention versus 21% post-intervention).
Conclusions: The implementation of the HBB-ECEB programs combined with supportive supervision improved the quality of care for newborns in terms of cord care, early skin-to-skin care and early initiation of breastfeeding. The rates of administration of ophthalmic ointment and vitamin K were high pre- intervention and remained high afterwards. These findings show that HBB-ECEB programs implemented with supportive supervision can improve quality of care for newborns.
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http://dx.doi.org/10.1186/s12884-018-2003-y | DOI Listing |
J Clin Med
January 2025
Exercise and Rehabilitation Sciences Institute, Postgraduate, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile.
To determine whether 448 kHz capacitive-resistive monopolar radiofrequency (CRMR) after platelet-rich-plasma (PRP) injections can further reduce pain sensation within the first 72 h in an active population with patellar chondropathy. One-hundred fifty-three active patients with patellar chondropathy grade II-III were followed for three days after PRP injections with and without CRMR under a control-placebo study. They were clinically evaluated for pain sensation using a visual analog scale ranging from zero (no pain sensation) to ten (highest pain sensation).
View Article and Find Full Text PDFInt J Qual Health Care
January 2025
Consultant and HOD of Emergency Medicine Dept, Christian Institute of health sciences and Research, Dimapur, Nagaland.
Introduction Human errors are a leading cause of disability and death among hospitalized patients. Globally, various strategies have been employed to reduce errors and to improve the quality of patient care. One such novel effort never attempted before is the Health-QUEST (Quality Upgradation Enabled by Space Technology) initiative which aims at translating the best quality and safety practices of the Indian Space Research Organization (ISRO) into the realm of emergency care.
View Article and Find Full Text PDFCureus
December 2024
Emergency Medicine, Whittington Health NHS Trust, London, GBR.
Introduction Ophthalmology presentations contribute significantly to Accident and Emergency (A&E) attendance. The provision of safe care depends on clinical skills and appropriate equipment. This quality improvement project aimed to increase the availability of ophthalmoscopes and Snellen charts required for a basic ophthalmological assessment in an A&E department in North London.
View Article and Find Full Text PDFLancet Infect Dis
January 2025
Institut Pasteur, Université Paris Cité, G5 Épidémiologie et Analyse des Maladies Infectieuses, Paris, France. Electronic address:
Background: Plasmodium vivax forms dormant liver stages (hypnozoites) that can reactivate weeks to months after primary infection. Radical cure requires a combination of antimalarial drugs to kill both the blood-stage and liver-stage parasites. Hypnozoiticidal efficacy of the liver-stage drugs primaquine and tafenoquine cannot be estimated directly because hypnozoites are undetectable.
View Article and Find Full Text PDFJ Am Coll Surg
January 2025
Department of Surgical Oncology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.
Introduction: Pathway-driven, post-pancreatectomy opioid reduction interventions have proven effective and sustainable and may have a "halo effect" on other major abdominal cancer operations. This study's aim was to analyze the sequential effects of expanding opioid reduction efforts from pancreatectomy on opioids prescribed after hepatectomy.
Methods: This is a retrospective cohort study utilizing data from the electronic health record and a prospective quality improvement database for consecutive hepatectomy patients (09/2016-02/2024).
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