Training programs to improve identification of sick newborns and care-seeking from a health facility in low- and middle-income countries: a scoping review

BMC Pregnancy and Childbirth

Alastair Fung¹  Lisa Avery²  Maryanne Crockett³  Elsabé Du Plessis⁴  Elisabeth Hamilton⁴  Nicole Askin⁵ 

[1] Hospital for Sick Children, Division of Paediatric Medicine, University of Toronto, 555 University Ave., Rm 10402, Black Wing, M5G 1X8, Toronto, Ontario, Canada;Institute for Global Public Health, Department Of Obstetrics, Gynecology and Reproductive Sciences, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Bldg, 771 McDermot Avenue, R3E 0T6, Winnipeg, Manitoba, Canada;Institute for Global Public Health, Department of Pediatrics and Child Health, Medical Microbiology and Infectious Diseases, Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Bldg, 771 McDermot Avenue, R3E 0T6, Winnipeg, Manitoba, Canada;Institute for Global Public Health, Rady Faculty of Health Sciences, University of Manitoba, R070 Med Rehab Bldg, 771 McDermot Avenue, R3E 0T6, Winnipeg, Manitoba, Canada;Neil John Maclean Health Sciences Library, Rady Faculty of Health Sciences, University of Manitoba, 727 McDermot Avenue, R3E 0T6, Winnipeg, Manitoba, Canada;

关键词: Newborn care;    Newborn;    Neonatal;    Training;    Care-seeking;    Low- and middle-income countries;    Human resources for health;   

DOI  :  10.1186/s12884-021-04240-3

来源: Springer

【 摘 要 】

BackgroundMost neonatal deaths occur in low- and middle-income countries (LMICs). Limited recommendations are available on the optimal personnel and training required to improve identification of sick newborns and care-seeking from a health facility. We conducted a scoping review to map the key components required to design an effective newborn care training program for community-based health workers (CBHWs) to improve identification of sick newborns and care-seeking from a health facility in LMICs.MethodsWe searched multiple databases from 1990 to March 2020. Employing iterative scoping review methodology, we narrowed our inclusion criteria as we became more familiar with the evidence base. We initially included any manuscripts that captured the concepts of “postnatal care providers,” “neonates” and “LMICs.” We subsequently included articles that investigated the effectiveness of newborn care provision by CBHWs, defined as non-professional paid or volunteer health workers based in communities, and their training programs in improving identification of newborns with serious illness and care-seeking from a health facility in LMICs.ResultsOf 11,647 articles identified, 635 met initial inclusion criteria. Among these initial results, 35 studies met the revised inclusion criteria. Studies represented 11 different types of newborn care providers in 11 countries. The most commonly studied providers were community health workers. Key outcomes to be measured when designing a training program and intervention to increase appropriate assessment of sick newborns at a health facility include high newborn care provider and caregiver knowledge of newborn danger signs, accurate provider and caregiver identification of sick newborns and appropriate care-seeking from a health facility either through caregiver referral compliance or caregivers seeking care themselves. Key components to consider to achieve these outcomes include facilitators: sufficient duration of training, refresher training, supervision and community engagement; barriers: context-specific perceptions of newborn illness and gender roles that may deter care-seeking; and components with unclear benefit: qualifications prior to training and incentives and remuneration.ConclusionEvidence regarding key components and outcomes of newborn care training programs to improve CBHW identification of sick newborns and care-seeking can inform future newborn care training design in LMICs. These training components must be adapted to country-specific contexts.

【 授权许可】

CC BY