Supporting Gaza’s youngest residents: Neonatal infection control

Gaza’s 10-year blockade and closure disproportionately affects its youngest residents. Earlier this year, UN OCHA identified that approximately 287,000 children and babies are vulnerable as a result of the deterioration of Gaza’s health sector and hampered access to essential health and nutrition services.

The risks are particularly severe for new-born babies. According to OCHA, 45% of child deaths under the age of five occur within the first 28 days of life – the neonatal period. In Gaza’s hospitals, care for new-born babies – particularly those in need of intensive care – is challenged by scarce medicines and supplies, and a lack of qualified health workers.

Recent shortages of fuel needed to run generators at Gaza’s hospitals – which only receive between eight to 12 hours of mains electricity per day – have further endangered the lives of some 100 new-born babies in intensive care units.

Since 2008 MAP has been supporting neonatal life support training for medical workers in obstetric (maternity) and neonatal units in Gaza, and providing the necessary medicines, disposables and equipment so that hospitals can save more babies’ lives.

Last month MAP supported a conference in Gaza, titled Management, Prevention and Control of Neonatal Infections, to help improve the health and survival rate of new born babies. Organised by the Gaza Neonatal Network (GNN), the conference brought together professionals in neonatology and infection control, staff involved in supporting neonatal services at the Ministry of Health (MoH) and other stakeholders such as non-governmental organisations.

Dr Ezzedin Gouta, UK-based neonatal life support specialist and MAP trustee, writes about the conference and how MAP’s work is helping to give the hope of a better start in life for babies in Gaza:

Globally every year 2.6 million neonates die; three quarters of these deaths occur in the first week of life, and almost all (99%) in low- and middle-income countries [1, 3]. Neonatal infection is a leading cause of neonatal mortality, only behind premature birth, pregnancy-related complications or birth asphyxia. It is a major public health problem, especially in developing countries [2]. It is responsible for 13% of all neonatal mortality, and 42% of deaths in the first week of life [2, 3]. Recent work undertaken by the WHO has shown that infection is an important cause of mortality in Gaza contributing to 29% of infant deaths [4].

The main aim of the conference was to increase awareness of healthcare professionals, service providers and sponsors of the current trends, epidemiology (the study of disease), practices and challenges of neonatal infection management and prevention, in order to create better health for new-borns in Gaza. The ultimate aim of the conference was to build on the ongoing work in this field in Gaza that has been led by MAP, and accordingly to reduce the burden of neonatal infections and its associated morbidity (disease within a population), mortality (death within a population) and long-term disabilities.

The challenges facing neonatal infections management and prevention in Gaza are mainly linked to lack of infection control resources, inadequate surveillance and data collection, issues related to training, lack of clear up-to-date infection control policies and guidelines, and a problem with lack of capacity and specialism in infection control and prevention.

Hospitals in Gaza, including those with neonatal units, suffer from severe and constant shortages of infection control supplies. This is believed to have a significant impact on the mortality and morbidity rates among newborn babies. This includes: essential drugs, consumables items, and equipment and other infection control supplies. All these items are necessary for provision of good quality medical care for patients in Gaza. Recently, the neonatal units identified shortages in the supply of essential items, and MAP supported the procurements of these. But there is a need for more investment and support, as constant availability and continuous supply of these is essential. More support is needed to ensure sustainability of this project, the need for which was addressed at the conference.

Outcomes for neonatal patients with infections can also be improved by following evidence-based practices. This was promoted in the conference through presentations which increased delegates’ awareness of and compliance with relevant up-to-date infection control and management guidelines and polices. Recent scientific advances to reduce the burden from neonatal infections in Gaza were discussed, and the conference provided an exciting new opportunity for continuous professional development, training and networking in the field of neonatal infections. Participants also had the opportunity to meet leading speakers in this area and to take part in debates and discussions. 

It is hoped that the participants have been updated on best practice for neonatal infection prevention and management, and that health care providers will respond to the needs of the clinicians and managers working in the neonatal units and work together to ensure having a more sustainable resources and investment in this important field. This can in turn reduce the burden of neonatal infections and its impact on morbidity, mortality and long-term disabilities.

 

References:

  1. Wang H, Liddell CA, Coates MM, et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384:957–79.
  2. Liu L, Johnson HL, Cousens S, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet 2012; 379:2151–61.
  3. Lawn JE, Cousens S, Zupan J, et al. 4 million neonatal deaths: when? Where? Why? Lancet 2005;365:891–900.
  4. Validation of UNRWA survey findings on Infant Mortality in Gaza:  Summary of Main Findings, August 2016; World Health Organization (WHO); Ministry of Health (MOH) Gaza.

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