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An innovative multipartner research program to address detection, assessment and treatment of neonatal infections in low-resource settings.

Qazi SA, Wall S, Brandes N, Engmann C, Darmstadt GL, Bahl R - Pediatr. Infect. Dis. J. (2013)

Bottom Line: The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.Published and nonpublished data on community-based approaches for the management of neonatal sepsis were critically reviewed by an independent expert panel convened in 2007 by the World Health Organization in collaboration with the United States Agency for International Development and Save the Children/Saving Newborn Lives.This research program facilitated innovative research in different geographical, cultural and administrative milieus to generate recommendations for policy.

View Article: PubMed Central - PubMed

Affiliation: Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland. qazis@who.int

ABSTRACT

Background: In pursuit of innovative approaches for the management of severe infections in young infants, which is a major cause of mortality, a multipartner research program was conceptualized to provide right care in the right place. The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.

Research: Published and nonpublished data on community-based approaches for the management of neonatal sepsis were critically reviewed by an independent expert panel convened in 2007 by the World Health Organization in collaboration with the United States Agency for International Development and Save the Children/Saving Newborn Lives. These stakeholders agreed to 1) undertake research to improve the specificity of a diagnostic algorithm and revise World Health Organization/United Nations International Children's Emergency Fund Integrated Management of Childhood Illness guidelines to identify sick young infants for referral, 2) develop research studies with common research designs (1 site in each Bangladesh and Pakistan and a multicentre site in Democratic Republic of Congo, Kenya and Nigeria) and oversight mechanisms to evaluate antibiotic regimens (when referral is not accepted by the family) that are safe and efficacious, appropriate to the severity of infection, and deployable on a large scale and 3) utilize existing program delivery structures incorporating community health workers, skilled health workers to deliver simple antibiotic treatment when referral is not possible.

Conclusions: This research program facilitated innovative research in different geographical, cultural and administrative milieus to generate recommendations for policy.

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Program framework and context of research.
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Figure 1: Program framework and context of research.

Mentions: One of the key considerations in the development of this multipartner research initiative was to nest it within the context of an existing program-based framework.9 It was not approached as a stand-alone intervention, but rather was intended to be integrated with other newborn and young infant care initiatives. Therefore, aspects of home-based newborn care, IMCI for infants, and treatment of serious infections in young infants where referral is not possible were combined into the approach (Fig. 1). Elements such as home visits, pregnancy surveillance, antenatal visits, preparation for birth, CHW home care training packages, IMCI for young infants, refusal of referral and treatment by a trained health worker at home or at a health facility are cornerstones of the approach used in this work. It is anticipated that the incorporation of the study into an existing program-based framework will facilitate successful execution of the study, and perhaps more importantly, ensure sustainability and institutionalization of ensuing newborn infectious disease policy changes within the national ministries of health.


An innovative multipartner research program to address detection, assessment and treatment of neonatal infections in low-resource settings.

Qazi SA, Wall S, Brandes N, Engmann C, Darmstadt GL, Bahl R - Pediatr. Infect. Dis. J. (2013)

Program framework and context of research.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3814851&req=5

Figure 1: Program framework and context of research.
Mentions: One of the key considerations in the development of this multipartner research initiative was to nest it within the context of an existing program-based framework.9 It was not approached as a stand-alone intervention, but rather was intended to be integrated with other newborn and young infant care initiatives. Therefore, aspects of home-based newborn care, IMCI for infants, and treatment of serious infections in young infants where referral is not possible were combined into the approach (Fig. 1). Elements such as home visits, pregnancy surveillance, antenatal visits, preparation for birth, CHW home care training packages, IMCI for young infants, refusal of referral and treatment by a trained health worker at home or at a health facility are cornerstones of the approach used in this work. It is anticipated that the incorporation of the study into an existing program-based framework will facilitate successful execution of the study, and perhaps more importantly, ensure sustainability and institutionalization of ensuing newborn infectious disease policy changes within the national ministries of health.

Bottom Line: The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.Published and nonpublished data on community-based approaches for the management of neonatal sepsis were critically reviewed by an independent expert panel convened in 2007 by the World Health Organization in collaboration with the United States Agency for International Development and Save the Children/Saving Newborn Lives.This research program facilitated innovative research in different geographical, cultural and administrative milieus to generate recommendations for policy.

View Article: PubMed Central - PubMed

Affiliation: Department of Maternal Newborn Child and Adolescent Health, World Health Organization, Geneva, Switzerland. qazis@who.int

ABSTRACT

Background: In pursuit of innovative approaches for the management of severe infections in young infants, which is a major cause of mortality, a multipartner research program was conceptualized to provide right care in the right place. The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.

Research: Published and nonpublished data on community-based approaches for the management of neonatal sepsis were critically reviewed by an independent expert panel convened in 2007 by the World Health Organization in collaboration with the United States Agency for International Development and Save the Children/Saving Newborn Lives. These stakeholders agreed to 1) undertake research to improve the specificity of a diagnostic algorithm and revise World Health Organization/United Nations International Children's Emergency Fund Integrated Management of Childhood Illness guidelines to identify sick young infants for referral, 2) develop research studies with common research designs (1 site in each Bangladesh and Pakistan and a multicentre site in Democratic Republic of Congo, Kenya and Nigeria) and oversight mechanisms to evaluate antibiotic regimens (when referral is not accepted by the family) that are safe and efficacious, appropriate to the severity of infection, and deployable on a large scale and 3) utilize existing program delivery structures incorporating community health workers, skilled health workers to deliver simple antibiotic treatment when referral is not possible.

Conclusions: This research program facilitated innovative research in different geographical, cultural and administrative milieus to generate recommendations for policy.

Show MeSH
Related in: MedlinePlus