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Kenya Plans. 2.6 million newborn deaths worldwide 1.1 million newborn deaths in Africa. 3 MAIN CAUSES. Prematurity 35% Respiratory Distress Thermal Instability Feeding Challenges Infection Jaundice Hypoglycemia. Infection 23% Sepsis Pneumonia Diarrhea Tetanus.
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2.6 million newborn deaths worldwide 1.1 million newborn deaths in Africa 3 MAIN CAUSES Prematurity 35% Respiratory Distress Thermal Instability Feeding Challenges Infection Jaundice Hypoglycemia Infection 23% Sepsis Pneumonia Diarrhea Tetanus Injured in Delivery 24% Hypoxic Brain Injury
Power of Partnerships: NEST Team • RICE University; Institute of Global Health • Northwestern University; Kellogg School of Management • 3rd Stone Design • London School of Hygiene and Tropical Medicine (LSHTM) • Center for Public Health and Development (CPHD) • Kenya Paediatric Association; KEPRECON • Oxford University; KEMRI-Wellcome Trust
Newborn Essential Solutions & Technologies (NEST) Hydration & Nutrition Prevent & Treat Infections Breathing Support Monitor & Treat Jaundice Separate Neonatal Ward Point-of-care Diagnostics Temperature Stability
NEST 360 Product Categories 4 5 8 Commercially available NEST facilities already equipped for Essential Newborn Care including resuscitation To be available (12-24 mo) To be available (24-48 mo)
EFFECTIVE AFFORDABLE SUSTAINABLE
Health System Approach • Newborn TWG integration • Focus • Newborn mortality burden counties • UHC Counties • Facility tech and clinical assessment • Hub and Spoke model • Learning sites • Implementing sites • In-service and Pre-service training • Inter Country Learnings and Best Practice Sharing
Kenya Implementation Plan Kenya Goal • Build NEST network and • develop model distribution system Learning questions • Refine district implementation; core neonatal records/data Outputs • Neonatal Record Set • Refined NEST Implementation & Planning Guide • Refined NEST Financing Metrics Toolkit • Model Distribution Network # project NESTs clinical teaching 15 12 65 # NESTs sold
What does it take? • Infrastructure • Space ~ at least 5m by 5m • Power – clean and stable • Equipment • Respiratory – CPAP, Oxygen, Pulse Ox • Temp – Warmer, Thermometer • Support – Suction, Glucometer, Phototherapy • Staffing • 1 nurse to 3 babies; 1 MO or Paediatrician/Neonatologist • Training – Biomed and Clinicians • Maintenance schedule All these would cost ~ KES 3M
Our Plan • Do baseline survey for Pumwani, Mama Lucy and NyeriCounty Referral Hospital • Give survey feedback to ICC and stakeholders in newborn health for Pumwani, Mama Lucy and Nyeri with action plan and involve interested partners to support in areas of their interest • Do baseline survey for 2 learning sites (Machakos & Nakuru), 2 learning hubs (MTRH, JOTRH) and one Medical Engineering training institution KMTC (Nairobi) • Roll out to other facilities as guided by TWG
We cannot reach the SDG for newborn survival without scaling comprehensive, quality newborn care (12 yrs to get to 12) Goal • NEST integrates product introduction, facility distribution, service & maintenance, training & mentorship to ensure sustained, effective use of life-saving technologies