Perinatal palliative care in sub-Saharan Africa: recommendations for practice, future research, and guideline development

Frontiers in Pediatrics

Pediatrics

Betelehem B. Kassa¹  Solomie Jebessa Deribessa²  Atnafu Mekonnen Tekleab²  Mahlet Abayneh²  Peter Odion Ubuane³  Brian S. Carter⁴  Stephanie K. Kukora⁴  Sharla Rent⁵ 

[1] College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia;Department of Pediatrics and Child Health, St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia;Department of Pediatrics, Lagos State University Teaching Hospital (LASUTH), Ikeja, Lagos, Nigeria;Division of Neonatology and Bioethics Center, Children’s Mercy Hospital, Kansas City, MO, United States;Department of Pediatrics and Department of Medical Humanities and Bioethics, University, of Missouri-Kansas City School of Medicine, Kansas City, MO, United States;Duke Department of Pediatrics, Duke School of Medicine, Durham, NC, United States;Duke Global Health Institute, Durham, NC, United States;

关键词: perinatal palliative care;    sub-saharan Africa;    neonatal intensive care;    newborn bereavement;    neonatal end-of-life care;    low-middle-income-countries;   

DOI  :  10.3389/fped.2023.1217209

 received in 2023-05-05, accepted in 2023-06-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

Worldwide, sub-Saharan Africa has the highest burden of global neonatal mortality (43%) and neonatal mortality rate (NMR): 27 deaths per 1,000 live births. The WHO recognizes palliative care (PC) as an integral, yet underutilized, component of perinatal care for pregnancies at risk of stillbirth or early neonatal death, and for neonates with severe prematurity, birth trauma or congenital anomalies. Despite bearing a disproportionate burden of neonatal mortality, many strategies to care for dying newborns and support their families employed in high-income countries (HICs) are not available in low-and-middle-income countries (LMICs). Many institutions and professional societies in LMICs lack guidelines or recommendations to standardize care, and existing guidelines may have limited adherence due to lack of space, equipment, supplies, trained professionals, and high patient load. In this narrative review, we compare perinatal/neonatal PC in HICs and LMICs in sub-Saharan Africa to identify key areas for future, research-informed, interventions that might be tailored to the local sociocultural contexts and propose actionable recommendations for these resource-deprived environments that may support clinical care and inform future professional guideline development.

【 授权许可】

Unknown   
© 2023 Abayneh, Rent, Ubuane, Carter, Deribessa, Kassa, Mekonnen Tekleab and Kukora.