INTRODUCTION TO
NEONATAL HEALTH
CARE
By:
HITAYEZU Jean Bosco Henri
AIM/Expectation
• To prepare midwifery students to provide competent and
compassionate care to newborns and their families,
ensuring a healthy start to life
OVERVIEW OF NEONATAL
MORTALITY
• Globally 2.3 million children died in the first 20 days of life in 2022
• Approximately 6500 newborn deaths every day
• 47% of all child deaths under the age of 5 years.
• Neonatal deaths declined from 5.0 million in 1990 to 2.3 million in 2022
• Sub-Saharan Africa had the highest neonatal mortality rate in 2022 at 27
deaths per 1000 live births, followed by central and southern Asia with 21
deaths per 1000 live births.
• In sub-Saharan Africa the risk of death in the first month of life is 11 times
higher than that in the lowest-mortality region, Australia and New Zealand.
WHY?
• 75% (ND) occur during the first week of life, and about 1 million
newborns die within the first 24 hours
• Leading causes of ND:
• Premature birth,
• Birth complications (birth asphyxia/trauma),
• Neonatal infections and
• Congenital anomalies
• What is the problem?
• Accessibility and availability of quality health care
COMMON NEONATAL
PROBLEMS
• Preterm birth complications
• Infections (Neonatal sepsis)
• Intrapartum-related Complications (Birth asphyxia,…)
• Neonatal jaundice
• Low birth weight
• Congenital anomalies/birth defects
• Neonatal Hypothermia
• Respiratory Distress Syndrome (RDS)
WHAT TO DO?/STRATEGIES
• To improve newborn survival should be built on a strong foundation:
• Essential newborn care and align with the Every Newborn Action Plan (ENAP)
• Ending Preventable Maternal Mortality (EPMM) targets on antenatal care, postnatal
care, skilled health personnel and emergency obstetric and newborn care.
• Increasing financing and allocating resources towards two very high-
impact but high-cost interventions
• Care for small and sick newborns and emergency obstetric care – are
critical
• The provision of midwife-led continuity of care (MLCC) can reduce
preterm births by up to 24%
Essential newborn care
• Thermal protection
• Hygienic umbilical cord and skin care;
• Early and exclusive breastfeeding;
• Assessment for signs of serious health problems or need of
additional care
• Preventive treatment
Families should be advised
to:
• Seek prompt medical care if necessary
• Register the birth; and
• Bring the baby for timely vaccination according to national
schedules
ADDITIONAL ATTENTIONS TO:
Low-birthweight and preterm babies:
• Increased attention to keeping the newborn warm,
• Assistance with initiation of breastfeeding,
• Extra attention to hygiene, especially hand washing;
• Extra attention to danger signs and the need for care; and
• additional support for breastfeeding and monitoring growth.
Sick newborns:
• Danger signs should be identified as soon as possible in health facilities or
at home
• If a sick newborn is identified at home, the family should be helped in
locating a hospital or facility to care for the baby.
ADDITIONAL ATTENTIONS TO:
Newborns of HIV-infected mothers:
• Preventive antiretroviral treatment (ART) for mothers and newborns to
prevent opportunistic infections;
• HIV testing and care for exposed infants; and
• counselling and support to mothers for infant feeding.
• Community health workers should be aware of the specialized issues
around infant feeding.
• Many HIV-infected newborns are born prematurely and are more
susceptible to infections.
WHO response-Work with
ministries of Health
• Strengthen and invest in primary healthcare
• Improve the quality of maternal and newborn care from pregnancy to the entire
postnatal period
• Expand quality services for small and sick newborns
• Reduce inequities in accordance with the principles of universal health coverage,
• Promote engagement of and empower mothers, families and communities to
participate in and demand quality newborn care; and
• strengthen measurement, programme tracking and accountability to count every
newborn and stillbirth.
SDG-Target by 2030
• A key target is to reduce neonatal mortality to at least as
low as 12 per 1,000 live births by 2030 through:
• improving access to quality healthcare,
• promoting essential newborn care practices,
• and increasing immunization coverage.
WHY MIDWIVES HAVE TO
STUDY NEONATOLOGY?
Women who receive midwife-led continuity of care (MLCC) provided by professional
midwives, educated and regulated to internationals standards, are 16% less
likely to lose their babies and 24% less likely to experience a pre-term birth.
• Identify and manage complications
• Provide immediate newborn care
• Support neonatal resuscitation
• Promote Kangaroo Mother Care (KMC)
• Educate and support parents
• Work in multidisciplinary teams
References
• World Health Organization. (2020). Newborns: improving survival and well-being. WHO.
•World Health Organization (WHO). (2020). Newborns: improving survival and well-being. WHO. Link
•Gomella, T. L., Eyal, F. G., & Bany-Mohammed, F. (2020). Gomella's Neonatology: Management,
Procedures, On-Call Problems, Diseases, and Drugs (8th ed.). McGraw-Hill Education.
•Stoll, B. J., & Hansen, N. I. (2021). Infections in Newborns. In R. E. Behrman, R. M. Kliegman, & H. B.
Jenson (Eds.), Nelson Textbook of Pediatrics (21st ed.). Elsevier.
•Murray, M. L., & Huhta, J. C. (2018). Manual of Neonatal Care (8th ed.). Lippincott Williams & Wilkins.
•Hockenberry, M. J., & Wilson, D. (2018). Wong's Nursing Care of Infants and Children (11th ed.). Mosby.
