BMJ Global Health (Mar 2021)
Small and sick newborn care during the COVID-19 pandemic: global survey and thematic analysis of healthcare providers’ voices and experiences
- Grace Irimu,
- David Gathara,
- Queen Dube,
- Peter Waiswa,
- Rajiv Bahl,
- Ivan Mambule,
- Eric Ohuma,
- Cally Tann,
- Joy E Lawn,
- Sam Newton,
- Sarmila Mazumder,
- Nita Bhandari,
- Sachiyo Yoshida,
- Eric O Ohuma,
- Harish Chellani,
- Araya Abrha Medhanyie,
- Abebe Gebremariam Gobezayehu,
- Aarti Kumar,
- Vishwajeet Kumar,
- Abiy Seifu Estifanos,
- Henok Tadele,
- Rashmi Kumar,
- Melissa M Medvedev,
- Chinyere Ezeaka,
- Msandeni Chiume,
- Rajesh Mehta,
- Abiy Seifu Estifanos,
- Kondwani Kawaza,
- Nahya Salim,
- Suman P N Rao,
- Nicole Minckas,
- Prashantha Y N,
- Alfrida Camelia Silitonga,
- Arun Singh Jadaun,
- Ebunoluwa A Adejuyigbe,
- Helen Brotherton,
- Sugandha Arya,
- Rani Gera,
- Chinyere V Ezeaka,
- Abdou Gai,
- Helga Naburi,
- Victor Tumukunde,
- Gyikua Plange-Rhule,
- Josephine Shabini,
- Fitsum W/Gebriel,
- Amanuel Hadgu,
- Lamesgin Alamineh,
- Elizabeth Molyneux,
- Irene Agyeman,
- Naana Wireko-Brobby,
- Ebunoluwa Adejuyigbe,
- Henry Anyabolu,
- Osagie Ugowe,
- Augustine Massawe,
- James Cross,
- Melissa Medvedev,
- Fitsum Woldegebriel,
- PN Suman Rao,
- Troy Cunningham,
- Prathibha Rai,
- YN Prashantha,
- Ved Prakash,
- Vinay Pratap Singh
Affiliations
- Grace Irimu
- professor
- David Gathara
- 2 KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Queen Dube
- Paediatric Department, University of Malawi College of Medicine, Blantyre, Malawi
- Peter Waiswa
- Global Public Health, Karolinska Institute, Stockholm, Sweden
- Rajiv Bahl
- Department of Medicine, World Health Organization, Geneva, Switzerland
- Ivan Mambule
- Paediatrics and Child Health Research Group, Malawi-Liverpool Wellcome Programme, Blantyre, Malawi
- Eric Ohuma
- Cally Tann
- 1 Maternal, Adolescent, Reproductive and Child Health Centre, London School of Hygiene and Tropical Medicine, London, UK
- Joy E Lawn
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
- Sam Newton
- Department of Global and International Health, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ashanti, Ghana
- Sarmila Mazumder
- Center for Health Research and Development, Society for Applied Studies, New Delhi, India
- Nita Bhandari
- Center for Health Research and Development, Society for Applied Studies, New Delhi, India
- Sachiyo Yoshida
- Eric O Ohuma
- 4 Maternal, Adolescent, Reproductive and Child Health (MARCH) Centre, London School of Hygiene & Tropical Medicine, London, UK
- Harish Chellani
- 24 Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
- Araya Abrha Medhanyie
- School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
- Abebe Gebremariam Gobezayehu
- Emory Ethiopia-Country Office, Addis Ababa, Ethiopia
- Aarti Kumar
- Community Empowerment Lab, Lucknow, Uttar Pradesh, India
- Vishwajeet Kumar
- Community Empowerment Lab, Lucknow, Uttar Pradesh, India
- Abiy Seifu Estifanos
- School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
- Henok Tadele
- College of Health Sciences, Department of Paediatrics and Child Health, Addis Ababa University, Addis Ababa, Ethiopia
- Rashmi Kumar
- Melissa M Medvedev
- Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
- Chinyere Ezeaka
- Msandeni Chiume
- Department of Pediatrics, Kamuzu Central Hospital, Lilongwe, Malawi
- Rajesh Mehta
- 14 WHO Regional Office for South-East Asia, New Delhi, India
- Abiy Seifu Estifanos
- Department of Reproductive, Family and Population Health, School of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Kondwani Kawaza
- Queen Elizabeth Central Hospital, Blantyre, Malawi
- Nahya Salim
- 6Muhimbili University of Health and Allied Sciences
- Suman P N Rao
- 3 Department of Neonatology, St John`s Medical College Hospital, Bangalore, Karnataka, India
- Nicole Minckas
- Institute for Global Health, University College London, London, UK
- Prashantha Y N
- 1 Department of Neonatology, St. John`s Medical College Hospital, Bangalore, India
- Alfrida Camelia Silitonga
- 7 Department of Reproductive, Maternal, Newborn, Child and Adolescent Health, World Health Organization, Country Office Indonesia, Jakarta, Indonesia
- Arun Singh Jadaun
- Center for Health Research and Development, Society for Applied Studies, New Delhi, India
- Ebunoluwa A Adejuyigbe
- Peadiatrics and Child Health, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Osun State, Nigeria
- Helen Brotherton
- 4MRC Unit The Gambia at London School of Hygiene and Tropical Medicine
- Sugandha Arya
- 11 Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
- Rani Gera
- Delhi, India
- Chinyere V Ezeaka
- Department of Paediatrics, Lagos University Teaching Hospital, Lagos, Nigeria
- Abdou Gai
- 10 Medical Research Council Unit The Gambia, at London School of Hygiene & Tropical Medicine, Fajara, The Gambia
- Helga Naburi
- 16 Department of Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Victor Tumukunde
- 18 Medical Research Council/Uganda Virus Research Institute and London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda
- Gyikua Plange-Rhule
- 20 School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Josephine Shabini
- 21 Bagamoyo Research and Training Centre, Ifakara Health Institute, Bagamayo, Tanzania
- Fitsum W/Gebriel
- Department of Pediatrics and Child Health, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- Amanuel Hadgu
- 19 School of Public Health, Mekelle University College of Health Sciences, Mekelle, Ethiopia
- Lamesgin Alamineh
- Emory Ethiopia-Amhara Regional Office, Bahir Dar, Ethiopia
- Elizabeth Molyneux
- Kamuzu University of Health Sciences, Blantyre, Southern Region, Malawi
- Irene Agyeman
- Naana Wireko-Brobby
- Ebunoluwa Adejuyigbe
- Henry Anyabolu
- Osagie Ugowe
- Augustine Massawe
- James Cross
- Melissa Medvedev
- Fitsum Woldegebriel
- PN Suman Rao
- Troy Cunningham
- Prathibha Rai
- YN Prashantha
- Ved Prakash
- Vinay Pratap Singh
- DOI
- https://doi.org/10.1136/bmjgh-2020-004347
- Journal volume & issue
-
Vol. 6,
no. 3
Abstract
Introduction The COVID-19 pandemic is disrupting health systems globally. Maternity care disruptions have been surveyed, but not those related to vulnerable small newborns. We aimed to survey reported disruptions to small and sick newborn care worldwide and undertake thematic analysis of healthcare providers’ experiences and proposed mitigation strategies.Methods Using a widely disseminated online survey in three languages, we reached out to neonatal healthcare providers. We collected data on COVID-19 preparedness, effects on health personnel and on newborn care services, including kangaroo mother care (KMC), as well as disruptors and solutions.Results We analysed 1120 responses from 62 countries, mainly low and middle-income countries (LMICs). Preparedness for COVID-19 was suboptimal in terms of guidelines and availability of personal protective equipment. One-third reported routine testing of all pregnant women, but 13% had no testing capacity at all. More than 85% of health personnel feared for their own health and 89% had increased stress. Newborn care practices were disrupted both due to reduced care-seeking and a compromised workforce. More than half reported that evidence-based interventions such as KMC were discontinued or discouraged. Separation of the mother–baby dyad was reported for both COVID-positive mothers (50%) and those with unknown status (16%). Follow-up care was disrupted primarily due to families’ fear of visiting hospitals (~73%).Conclusion Newborn care providers are stressed and there is lack clarity and guidelines regarding care of small newborns during the pandemic. There is an urgent need to protect life-saving interventions, such as KMC, threatened by the pandemic, and to be ready to recover and build back better.