WHY?
Evidence-based, high-quality treatment and care are provided in a timely, people-centred manner by a well-trained, specialised multidisciplinary team. Safe staffing levels improve health outcomes and enhance staff satisfaction.
• Newborn health is closely linked to adequate numbers of qualified nurses and/or midwives working per shift in a newborn unit.
• Multidisciplinary teams provide the necessary skill set to deliver appropriate high-quality inpatient care. Specialists help enhance feeding, neurodevelopmental, and social outcomes of the baby and form part of a broader support system for families during and after hospital stay.
• Avoid harm to newborns who are receiving more advanced clinical care including, for example, appropriate supplemental oxygen. Disabilities can be prevented or mitigated with good-quality, developmentally-supportive care.
• Pain affects brain development with potentially long-term effects: It can lead, e.g., to hypersensitivity to pain at school age as well as older and lower motor and intellectual developmental indices. Healthcare providers should ensure that newborns do not experience discomfort and painful procedures where possible and apply interventions that relieve pain during necessary painful procedures.
• Outcomes for babies can be improved by delivering developmentally supportive care to babies born too soon, small, or sick. This includes, for example, respecting a baby’s sleep, paying attention to correct positioning, minimising noise and light, recognising signs of stress, and pausing interventions when possible.
HOW?
Ensure optimal working conditions including sufficient resources, adequate staff training, and supervisory support as well as support by hospital managers and health policy makers. Promote respect for healthcare providers and their work.
• Provide specific and continued training / continuous professional development and supportive supervision to advance skills and competencies, including safe use of WASH (Water, Sanitation, and Hygiene) and IPC (Infection, Prevention, and Control) facilities.
• Respect and recognise the profession and highly intense working conditions and responsibilities with, e.g., incentives such as increased remuneration, career opportunities, or establishment of a neonatal nursing cadre.
• Establish innovative approaches to motivate and facilitate the work of clinical staff and identify ways to prevent distress and burn-out.
• Ensure each level of care has the necessary staff per shift, equipment, commodities, supplies, and diagnostics so that providers can safely care for babies born too soon, too small, or too sick.
• Identify and procure diagnostics/equipment that are affordable, safe, effective, and appropriate for use in low resource settings.
• Establish clean, functional health centres to support safe delivery and empower women and families to demand and access quality health services from clean and safe healthcare facilities. Highlight the importance of respectful care, particularly for women at risk of disrespect and abuse due to age, socioeconomic status, or marital status. Determine conditions under which disrespect and abuse happen and put in place reporting and redress mechanisms.
With gratitude to: Survive and Thrive: Transforming care for every small and sick newborn, WHO, 2019.