A research group based at KEMRI-Wellcome Trust – Kenya and Oxford University has developed a free smartphone app for training health workers called “LIFE” which was launched during the Kenya Paediatric Association 2019 annual conference in Mombasa, Kenya.

The Life-saving Instruction for Emergencies (LIFE) smartphone app uses interactive 3D simulations of life-threatening emergencies to train healthcare workers to save lives. The simulations take place in a virtual 3D hospital where users have to find the correct pieces of medical equipment to manage an emergency and then use this equipment to carry out a sequence of life-saving steps. At the end of the simulated emergency, if they have carried out the steps correctly, the LIFE system awards a digital Continuing Professional Development (CPD) credit that is registered with the Kenya Paediatric Association (KPA).

There is a desperate need for new methods to train the growing numbers of healthcare workers around the world, particularly for managing emergencies in children. In Africa, approximately 1 million children die in their first month of life and the World Health Organization (WHO) estimates that two-thirds of these children could be saved if the healthcare workers who look after them had adequate training and resources.

Currently available face-to-face training programmes for healthcare workers are expensive and are associated with knowledge decay over time requiring frequent refresher training which only adds to the cost and inconvenience. To overcome these challenges, LIFE has been designed as a freely available app that all healthcare workers can download onto their own smartphones. The LIFE app reminds users on their phones when they need to refresh their training so that they can quickly test their knowledge to ensure they are always ready to act in an emergency. The LIFE app issues CPD credits each time they refresh their knowledge so that healthcare workers are rewarded with professional recognition for keeping up-to-date.

The development of the LIFE app was initially funded by contributors to a crowdfunding campaign, including the Skoll Foundation, HTC, and Medicins Sans Frontieres, with matched funding from the Wellcome Trust. The LIFE team went on to win funding from the Saving Lives at Birth Grand Challenge for Development (funded by the Bill and Melinda Gates Foundation, USAID, DFID, KOICA and Grand Challenges Canada). In 2018, LIFE won the “VR for Impact” award from HTC at the World Economic Forum in Davos to develop a Virtual Reality version of the app.

Healthcare workers around the world can now download the LIFE app for free from www.oxlifeproject.org or the Google PlayStore https://play.google.com/store/apps/details?id=uk.ac.ox.NDM.LIFE

For babies who are born healthy, the World Health Organisation (WHO) recommends to delay cord clamping . It means that the umbilical cord is not clamped immediately after birth but after waiting one to three minutes. That way, the baby is still connected to the placenta and receives oxygen rich blood and essential nutrients.
However, ill or preterm born babies often require immediate care and are therefore removed from the mother. This is where Concord Neonatal, a start-up from the Netherlands, come into play: they just introduced a new solution, Concord, that enables caregivers to provide care immediately after birth with the umbilical cord still intact until the baby is stable and breathing on its own.

Read more here:

#NewbornHealthReloaded

The European Standards for Newborn health were launched at the end of 2018 with a call to action. 220 health professionals and parent organisations from 30 countries were involved in developing the standards which cover 11 broad themes from birth through to ongoing infant and family centred care.

An information booklet on the standards can be found here:

www.efcni.org/news/brochure-about-european-standards-of-care-for-newborn-health/

And the standards are available for download here:

 

Image result for european standards of care for newborn health

We recently came across an interesting leadership book-The Leadership Challenge by Kouzes and Posner.

It sets out 5 Practices and 10 Commitments for exemplary leadership. We challenge you to ask yourself how many of the 10 commitments you meet as a leader? It might be food for thought and prompt revision of your leadership style?!

Click below for a PDF of the book :

https://edisciplinas.usp.br/pluginfile.php/3988308/mod_resource/content/2/LEADERSHIP%20CHALLENGE.pdf

and here for a link to their website:

http://www.leadershipchallenge.com/home.aspx

Nigeria’s ‘Flying Midwives’ Are Helping Save Moms and Babies

Nigeria is a risky place to give birth. Around 58,000 mothers die in childbirth in Nigeria every year, and 240,000 newborns within 28 days of birth. Despite being the wealthiest country in Africa by GDP, it ranks fourth in maternal mortality globally. But the situation is especially bad in the northeast of the country. Here in Borno state, which is at the epicenter of a decade–long Islamist insurgency led by Boko Haram, more than 6,500 newborns die every year of preventable causes—twice the rate of the rest of the country, according to the Nigerian government. And approximately 3,500 to 4,500 women die yearly because of causes related to childbirth.

Read more here:

Early total enteral feeding – An effective intervention to improve outcomes in very low birth weight (VLBW) neonates in resource limited settings.

Early appropriate nutrition and infection prevention are vital for the survival of a preterm infant. These issues are interconnected when delayed enteral feeds leads to intravenous intervention, which can result in infection.

Read more here:

Improving access to relevant, reliable and evidence-based healthcare information has enormous potential to radically improve healthcare and outcomes worldwide.

NNASA and COINN are active participants in this forum. We recommend you read the article below about its work and considering joining. Its free!

https://bmjpaedsopen.bmj.com/content/2/1/e000352

Factors Impacting Practice of Home Kangaroo Mother Care with Low Birth Weight Infants Following Hospital Discharge

To identify enablers and barriers related to home Kangaroo Mother Care (KMC) adoption after hospital discharge.

Read more here:

As members of NNASA you are also members of the Healthy Newborn Network. Over the next few days we will be highlighting a few articles/resources from their recent newsletter. Up first:

Breastfeeding Advocacy Toolkit – An Online Resource for Breastfeeding Promotion and Support

This month’s launch of the Collective’s Breastfeeding Advocacy Toolkit marks the release of an important online resource that stakeholders can use to advocate for the Collective’s seven policy actions globally and at the country level. This resource is for policy makers and country governments seeking information and tools to advocate for strengthening the protection, promotion, and support of breastfeeding, whether at the national or subnational (i.e. district) level. The Toolkit features sections on general advocacy guidance, country experience and tools, key policies and guidelines and global evidence for breastfeeding. Guidebooks, advocacy briefs, educational videos, and case studies as well as resources in multiple languages are available.

Click here to read more.

 

WHO has been made aware of multiple, recent reports of eye injury, including blindness, with the use of
chlorhexidine gluconate 7.1%, in nine countries in sub Saharan Africa.

Chlorhexidine gluconate (CHX), available as an aqueous solution or as a gel (delivering 4% chlorhexidine), is used in umbilical cord care, and is listed in the WHO Essential Medicines List. WHO recommends daily chlorhexidine (4%) application to the umbilical cord stump during the first week of life for newborns who are born at home in settings with high neonatal mortality (neonatal mortality rate>30 per 1000). Clean, dry cord care is recommended for newborns born in health facilities, and at home in low neonatal mortality settings. Use of chlorhexidine in these situations may be considered only to replace application of a harmful traditional substance such as cow dung to the cord stump. The use of CHX is being implemented in many countries (South Asia and sub-Saharan Africa) as part of a package of essential newborn interventions to reduce the incidence of omphalitis.

CHX causes serious harm if mistakenly applied to the eyes, resulting in severe eye injuries. Over forty
(40) cases of such incorrect administration are recorded, either as media reports, or in the literature,
since 2015. Injuries associated with both the liquid and gel (ointment) formulations have been reported
when CHX was mistaken for eye drops or ointments.
The present Alert is being issued to warn all stakeholders involved in the umbilical cord care
programmes about this potential misadministration and risk of serious injury with CHX. All healthcare
professionals, caregivers and others involved in its distribution, use and / or administration are advised
to take all necessary measures and precautions to ensure its correct use and administration.
Suggestions to National Neonatal and Reproductive Health Programmes and/or Regulators include the
following:
• Assess what products are part of the newborn package and select the optimal primary
container/dosage form for CHX or modify the design of the container to distinguish the product
from other medicines typically used for newborns.
• Update the product label with appropriate information on the safe use of the product.

• Develop more detailed instructions for users (flyers, posters, pictorials etc.) that are culturally
appropriate and easy to understand, to ensure correct use of the product.
• Train health care professionals who interact with mothers and/or provide the product to ensure
the full understanding of the indications and contraindications for use and application methods.

All stakeholders are advised to remain alert to incidents of eye injury with CHX in their settings and to
report these to their National Regulatory Authority (NRA). Member States are reminded that adverse
events associated with the use of any medicinal product should be reported to the National Regulatory
Authority.
For any questions relating to this alert please contact Dr S Pal (pals@who.int) or Dr J Simon
(simonjo@who.int).

i https://www.who.int/medicines/publications/essentialmedicines/en/
ii https://www.who.int/maternal_child_adolescent/documents/postnatal-care-recommendations/en/ (page 3)