Neonatal survival interventions in humanitarian emergencies: a survey of current practices and programs

Abstract

Background: Neonatal deaths account for over 40% of all deaths in children younger than five years of age and neonatal mortality rates are highest in areas affected by humanitarian emergencies. Of the ten countries with the highest neonatal mortality rates globally, six are currently or recently affected by a humanitarian emergency. Yet, little is known about newborn care in crisis settings. Understanding current policies and practices for the care of newborns used by humanitarian aid organizations will inform efforts to improve care in these challenging settings.

Methods: Between August 18 and September 25, 2009, 56 respondents that work in humanitarian emergencies completed a web-based survey either in English or French. A snow ball sampling technique was used to identify organizations that provide health services during humanitarian emergencies to gather information on current practices for maternal and newborn care in these settings. Information was collected about continuum-of-care services for maternal, newborn and child health, referral services, training and capacity development, health information systems, policies and guidelines, and organizational priorities. Data were entered into MS Excel and frequencies and percentages were calculated.

Results: The majority of responding organizations reported implementing components of neonatal and maternal health interventions. However, multiple barriers exist in providing comprehensive care, including: funding shortages (63.3%), gaps in training (51.0%) and staff shortages and turnover (44.9%).

Conclusions: Neonatal care is provided by most of the responding humanitarian organizations; however, the quality, breadth and consistency of this care are limited.

Figure 1

Provision of antenatal care (top) and childbirth services (bottom) in humanitarian emergency settings.

Figure 2

Provision of preventive (top) and therapeutic (bottom) newborn services in humanitarian emergency settings.

Figure 3

Barriers to providing newborn care services in humanitarian emergency settings, by organization type: open bar = governmental organization; solid bar = non-governmental organization; hatched bar = United Nations organization.