Innovative new units to prevent child deaths

INFANT mortality is expected to significantly decline in Zimbabwe, as the country’s largest referral hospital, Parirenyatwa Group of Hospitals, will soon open an immediate kangaroo mother care unit and paediatric theatre to cater for premature babies and their mothers.

Health experts say these innovations are “revolutionary” and will reduce the infant mortality rate that — according to the United Nations Children’s Fund — currently stands at about 50 deaths per every 1 000 live births.

Set up at an estimated cost of US$500 000 and $130 000, respectively, the IKMC and theatre will start operating in June this year.

The IKMC is a novel innovation that will operate as an intensive care unit, accommodating both mother and baby.

Instead of placing a new-born preterm baby in an incubator soon after delivery, the infant is immediately placed on the mother’s chest to receive necessary treatment that includes ventilation, antibiotics and intravenous fluids.

In addition, the infants are expected to stay in the delivery suit for an hour after being born while obstetricians and midwives monitor the mother in case of bleeding.

After the obstetricians and midwives are satisfied with the condition of the mother, she and the baby will be transferred to the neonatal unit, where it will stay on the mother’s chest for at least 18 hours.

The new innovation is a shift from the method where pre-term babies were placed in incubators before being introduced to kangaroo care when they weighed at least 1 300 grammes, off intravenous fluids and oxygen.

However, with pre-term babies’ risk of dying being high in the first 48 hours, it was observed that they never had the opportunity to benefit from the kangaroo mother care unit.

Also, with a single incubator costing up to US$40 000 to US$50 000, the IKMC will be cost-effective, reduce neonatal mortality and infections and promote breastfeeding.

PGH chief executive officer Dr Tsitsi Magure on Friday said work on the project was at an advanced stage.

“Very soon, we are going to launch a state-of-the-art immediate kangaroo mother care unit for pre-term babies . . . it is the first of its kind at the hospital,” she said.

Neonatologist and one of the experts spearheading the initiative, Dr Alex Stevenson said they had serious challenges with incubators.

“The incubators are expensive and we would mostly get them as second-hand and this caused difficulties such as running out of spare parts.

“So, we always have complications like babies getting cold, mortality of our babies goes up significantly in winter and the nurses are always asking for more incubators,” he said.

The new innovations, he added, will be rolled out in other parts of the country.

“We have plans to extend it to Murambinda Mission Hospital in Buhera, Sally Mugabe Central Hospital and other areas in the future. We have an amazing team across the board of nurses, lactation specialists, doctors, administration and parents’ representative.

“We are trying to achieve a revolution in our culture of the way we deliver care. We want to have an area that we are proud of, that is excellent and world class, where we can never make an excuse that a baby died because we didn’t have this or that,” said Dr Stevenson.

The specialists also collaborated with counterparts in India, where the largest IKMC was set up.

“The unit is also expected to promote baby-mother bonding, giving psychological benefits and improved intellectual outcomes for the baby,” said Dr Stevenson.

About four years ago, the World Health Organisation carried a research trial on the IKMC, whose results instantly proved its success.

Public health expert and University of Zimbabwe lecturer Dr Johannes Marisa said the setting up of the IKMC unit is a massive breakthrough in childcare.

“This is actually a very huge milestone to have because we will reduce mortality. Once you introduce the IKMC unit, it means those premature babies will have high chances of survival. That is a very good step in the right direction. So, of course, this is sweet news for mothers,” he said.

Ms Tendai Mutema, a mother of two premature babies and a parent representative in a research project done by local experts, noted the contrasting experiences she went through before and when IKMC was implemented locally.

She felt like an outsider as she watched her first baby, born in 2012 when IKMC was not yet available, struggling to breastfeed and bond in an incubator.

She bonded better with the second one, who went through IKMC, when she weighed 700g.

“I was able to exclusively breastfeed until she turned two. I had many fears, of course, of passing infections onto her but with the encouragement from the hospital team, I eventually felt I was at the safest place for my baby to grow.”

Sunday Mail

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