Global Survey of Perceptions, Experience and Recommendations for Advancing Community-Based Interventions for Birth Asphyxia
Gary L. Darmstadt, Ananta Manandhar, Joy E. Lawn. Saving Newborn Lives, Save the Children, USA, Washington, DC; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD; International Perinatal Care Unit, Institute of Child Health, London, United Kingdom; Cape Town, South Africa.
BACKGROUND: “Birth asphyxia” accounts for approximately 23% of the estimated 4 million neonatal deaths annually, and 26% of the estimated 3.9 million stillbirths. Given the paucity of evidence-based data available regarding community-based birth asphyxia prevention and management in developing countries, a global survey was conducted of experts in the field.
OBJECTIVE: To identify feasible ways to recognize birth asphyxia, perceived feasibility of effective interventions, and priority gaps in programs and research to address asphyxia at community level.
RESULTS: Respondents included 173 individuals from 32 countries and a wide variety of roles in international health care. Difficulty in identifying asphyxia and collecting meaningful information to guide decisions about asphyxia interventions was a major concern. The most feasible and useful methods identified for recognition of asphyxia were lack of crying or breathing at birth. Program recommendations for interventions during pregnancy included antenatal care and birth preparedness; communication of danger signs to families, TBAs and community health workers (CHWs); and basic obstetric care. Neonatal resuscitation and strengthening of the referral system were also identified as effective, but less feasible. Implementation of behavior change interventions was revealed as a major gap.
CONCLUSIONS: This survey highlights the wide range of responses required from all involved along the pathway to survival, including family, community, health care providers and policymakers. Most programs focus on training skilled attendants and newborn resuscitation, with little action where most deaths occur at the community level. A consensus in program and research priorities was identified. The international community must now act to apply these priorities to reduce the burden of deaths related to asphyxia, many of which occur in the world's poorer homes and communities.
PAS 2005: 57: 2413
Tuesday, May 17, 2005 11:15 am, Washington Convention Center - Room 207 A
Platform Session: Global Perspectives on Birth Asphyxia, Part II (10:30 AM - 12:30 PM)
Course Number: 7350