Recorded presentation

Stephen Nelson Wall, MD, SM, MSW¹, Joy E Lawn, BM BS MPH MRCP², and Gary Darmstadt, MD¹. (1) Saving Newborn Lives, Save the Children, 2000 M Street, NW, Suite 500, Washington, DC 20036, 202-530-4375, swall@dc.savechildren.org, (2) International Perinatal Unit, Institute of Child Health, 30 Guilford St., London, WC1N 1EH, United Kingdom

Birth asphyxia accounts for 30% of the 4 million neonatal deaths and approximately 40% of the estimated 3.9 million stillbirths annually. While neonatal deaths due to infections--especially neonatal tetanus--have declined globally, deaths due to birth asphyxia have remained largely unchanged in developing countries. Whereas most births and neonatal deaths occur at home, effective strategies to reduce global burden from birth asphyxia (neonatal deaths and stillbirths) must target community interventions.

A systematic literature review was conducted to identify promising community-based strategies to reduce neonatal deaths (and stillbirths) due to birth asphyxia. The review identified the following evidence-based strategies. Birth preparedness reduces delays in problem-recognition, decision-making, transportation, and timely receipt of care. Training traditional birth attendants (TBAs) may play roles in reducing asphyxia-related neonatal mortality, particularly where no skilled birth attendant (SBA) is available. Home-based care by community workers improves perinatal and neonatal care by increasing birth preparedness, safe delivery, and basic resuscitation. Maternity waiting homes and tools to predict need for emergency care increase access to emergency services for mothers and neonates in remote areas. Skilled attendants and neonatal resuscitation are potentially effective interventions, but require elements of a functioning health system. Perinatal audits improve quality by identifying opportunities to address lapses in perinatal care and health systems.

Based on evidence from this review, several research initiatives have been launched to examine cost-effectiveness of community-level interventions to prevent and manage birth asphyxia in developing countries. This review and results from ongoing studies provide important insights to reduce neonatal mortality.

Learning Objectives:

• Identify the evidence for community-based approaches to prevent and manage birth asphyxia in developing countries.

Keywords: International MCH, Perinatal Outcomes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Save the Children (employer)
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation