Infant Mortality: a Case Study

Theresa Curtis Intro to Global Health Case Study: Infant Mortality Each year approximately 10 million babies do not breathe immediately at birth, of which about 6 million require basic neonatal resuscitation. The major burden is in low-income settings, where health system capacity to provide neonatal resuscitation is inadequate. Many of these babies die because their birth attendant or caregiver did not know a simple technique called neonatal resuscitation. Neonatal resuscitation is important because it is a technique that can and will save a baby’s life.

Birth asphyxia is one of the leading causes of infant mortality, cerebral palsy and mental disabilities worldwide. In this case, we were asked to look at the China Neonatal Resuscitation Program. Why is this program important and why was China the country in the most need to have the program implemented? The program is important because more than twenty percent of chinese children die from birth asphyxia. In China 17 million children are born every year. And The idea that children have to die because a nurse is not trained to resuscitate the child is sad.

We, as americans are used to the big medical centers and if something happen we know that our child will be in good hands. The Key players in bringing rescuscitation to china was the American Academy of pediatrics. The program was first introduced in 1987 and it failed. I guess at the time there was not enough funding and of course when something new is introduced in the medical world, doctors or administrators are not quick to accept new techniques. I think of all that children that lost their lives because doctors and nurses were not trained to administer CPR or mechanical ventilation.

The Chinese Society of Perinatal Medicine provided obstetricians and neonatologst. The Chinese Nursing Association provided nurses professional education and training in resuscitation. They also included midwives in the training because midwives do not use resuscitation techniques during births. The Freedom of Breath Foundation of life Program was developed to reduce infant mortality rates by ensuring there is at least one skilled neonatal resuscitation provider at every delivery. After five years, that goal has been reached, nd more than 100,000 medical professionals from more than 20 provinces have been trained. In studies conducted by the China Ministry of Health, birth asphyxia mortality declined by 53 percent in 360 hospitals surveyed. (AAP. ORG) The future of the program is other countries being introduced to neonatal resuscitation. If the program worked for china than whose to say, it would not work for other countries. I wanted to research and find what other countries have implemented neonatal resuscitation since China.

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There is a similar program in Bangladesh. Before the program was implemented, the traditional way to resuscitate was to hold the baby upside down, slap the bottom or blow in the baby’s face. The only suctioning was of the mouth and nose. The main barriers to effective resuscitation are lack of competent staff and lack of simple equipment. Aga Khan University with UNICEF launched a program to improve resuscitation skills of Physicians, Nurses, and Midwives.

I hope that all countries are able to implement a neonatal resuscitation program in the hospitals but also go out into the communities and share the technique with those that give birth at home. It is known that many women do not go to medical facilities to give birth. Therefore, there need to be a nurse or midwives that can go out into the village, community, to teach the home nurse how to give proper resuscitation. My five-year goal would be that all people know how to administer neonatal resuscitation.

Many children are lost because they come out and they are not breathing. However, if more than one attendant knows the procedure more children can be saved. I would all medical personnel trained and re-trained every six months. It is important to maintain skills. In many countries the father is not apart of the birth, and maybe they should be. A male instructor can train and show the father during a home birth how to resuscitate if needed. It can be the difference between life and death. Freedom of Breath, Freedom of life |Helping babies breathe | | |Designed to train birth attendants in developing countries in the area| |First to successfully bring neonatal resuscitation to china, in a |of newborn resuscitation. | |systematic and sustainable way. | | |Was developed to reduce the infant mortality rate by always having a |Has a train the trainer approach.

Train the nurses and midwives in the| |person trained and skilled in neonatal resuscitation at delivery. |area of resuscitation before they go into the hospital and train | | |fellow nurses and midwives. | |Grew to national scale having 190 certified instructors and 44,000 |Trained 31 facilitators and 102 learners. however, the majority of | |practitioners trained |participants could not demonstrate mastery of bag and mask ventilation| |The rate of birth asphyxia declined by more than a third. | |Providers’ skills and confidence have increased and more babies are |Participants in a program for neonatal resuscitation in | |surviving. The program is saving lives and improving the health of |resource-limited settings demonstrated high satisfaction | |women. | | References www. aap. org www. ncbi. nlm. nih. gov www. jnj. com/giving-breath-to-life www. unicef. org/rosa/newborn

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