The creation of a sustainable low-cost “first-seven-days-of-life” Isolation unit at a Nigerian tertiary centre supplemented by a low-cost community-empowered neonatal emergency transport system and a PHC-operated neonatal basic care.
This proposal is being articulated based on deficiencies and compromises of actual practice standards as observed in neonatal centres across the entire regions of Nigeria. The World Health Organisation (WHO) cited a demographic study of 2008, quoting that 79% of neonatal deaths in Nigeria occurred in the first 7 days of life. Average daily neonatal death was estimated at 781
- CLICK for more detail - Maternal and Perinatal Health Profile for Nigeria
- CLICK for more detail - Maternal, Newborn & Child Survival (Countdown to 2015)
There have been several Millennium Development Goal (MDG) intervention programmes based on conventional approaches in Nigeria since 2009. However, by implication, UNICEF publication of 2013 stated an estimated average daily neonatal death of 761; a reduction of only 2.6% over 5 years. Over the last couple of years, a number of unconventional frugal approaches at the tertiary care level have been tried and validated in a few Nigerian centres by H. O. Amadi and colleagues. They measured the national average facility-based neonatal mortality rate (NNMR) before the application of their ideas at 254/’000 presentations
- CLICK for more detail - UNICEF - Nigeria Statistics
In a more recent publication of 2014, the average facility-based NNMR for non-participating (control) centres was estimated at 250/’000 presentations; a reduction of 1.6% in about 5 years.
- CLICK for more detail - International Journal of Pediatrics
This figure is quite similar to WHO and UNICEF statistics mentioned earlier. However, for the centres that participated in the new ideas, the national average NNMR was quantified at 114/’000 presentations; a reduction of 55% during the same time period. We propose to translate these unconventional ideas into versions that are applicable at the community health centres to address referral cases from the 80% birth population that occur in such difficult-to-reach places, effectively collaborating with designate tertiary centres.
Our primary focus will address the first seven days of life involving the development of:
(1) a neonatal basic care (NBC) system at the community level,
(2) a neonatal rescue scheme (NRS), which is a referral transport technique operated by local people and aimed at presenting the needy neonate with good vital signs at the tertiary hospital’s point-of-admission and
(3) a tertiary special-care-unit subsection, exclusively dedicated for the first 7 days of life.