Comprehensive Neonatal Health Project

Cerebral palsy and other disabilities linked to poor neonatal care represent a staggering 25 percent of all child disabilities. (UNICEF China, 2009)

Using the lessons learnt from our Neonatal Intensive Care Unit (NICU) Program, our experience with other diverse programming in China and with consultations with our partners and the China Medical Advisory Board, CMF is implementing a pilot project that will further our goal of improving newborn health in China. This comprehensive solution will look to reduce the rate of death of newborns in China, focusing on rural areas in Western China. Working closely with local partners, we will improve the level of care provided to newborn babies through providing equipment and training while addressing the most urgent needs and service gaps. We see this model as one that will provide a lasting and sustainable impact.

Our pilot project is taking place in Guizhou Province (贵州省) in the southwest region of China.

  • GDP: USD 1,017 in 2007 – the poorest province in China
  • Population: 38 million with 16% categorized as poor households
  • High Infant Mortality Rate: 22.22‰ compared to national 15.3‰ - the fourth highest province in China
  • Relatively High Birth Rate: 1.328% compared to national 1.214%
  • CMF Network: Two CMF NICUs were previously established in Guiyang (贵阳) and Zunyi (遵义)

Currently, the pilot project is being completed in Zunyi and Guiyang, Guizhou Province and has been launched in Sichuan Province. In the next 5 years, CMF will be expanding the Comprehensive Neonatal Health Program to 13 additional sites (with the establishment of 10 new NCUs) in three provinces in Western China: Guizhou, Yunnan and Sichuan Province.

Our Comprehensive Neonatal Health Program consists of five components

Establishment of a Neonatal Care Unit

Neonatal mortality (death in the first four weeks of life), tops the list of preventable causes of child death in China accounting for 60% of all childhood deaths. (UNICEF China, 2009)

CMF provides the training and equipment necessary to establish a specialized hospital unit to improve the care available to critically ill newborn babies. Two doctors and two nurses undergo 6-month intensive training and clinical experience in neonatology at our partner training hospitals, the Children’s Hospital of Fudan University and the Shanghai Children’s Medical Center. CMF also funds the purchase of specialized life-saving equipment for newborns and provides project management support. Participating hospitals commit to covering ongoing administrative, human resources, and equipment maintenance costs related to the establishment of the unit. This is an extension of our successful NICU program. In 2012, we have officially opened our 21st and 22nd Neonatal Care Unit in Bijie, Sichuan and Tongren, Sichuan.

Neonatal Resuscitation Training Program (NRP)

The main causes of neonatal mortality (death in the first four weeks of life) are asphyxia (due to lack of oxygen before delivery), low birth weight and infection. Many of these deaths can easily be prevented. (UNICEF China, 2009)

CMF has set up a Train-the-Trainer program with our partner training hospitals in Shanghai; 6 healthcare professionals from each participating region attend a week-long training session to become trainers in neonatal resuscitation and basic newborn baby emergency care. These trainers then return to their home hospitals and train at least 120 doctors and nurses in surrounding county, township and village level healthcare facilities. These trainers also provide onsite supervision for each participating doctor and nurse – the unique onsite supervision component of our program will give these healthcare professionals a supervised clinical experience that will help them build the confidence required to use the techniques learned in training. By training healthcare professionals at the local level we are able to have locally co-developed (with our training partners in Shanghai) training curricula to ensure that the contextual challenges of each region are taken into consideration and that the capacity for NRP training remains in the region.

Mobile Emergency Response Unit Program

A key concern for maternal and newborn health in China is the large disparity between coastal and urban areas and remote rural communities. (UNICEF China, 2009)

CMF sets up a Mobile Emergency Response Unit (MERU) Program at each participating region and provides the necessary equipment to help transport babies-at-risk in outlying areas to our specialized Neonatal Care Unit hospitals. Many healthcare facilities in rural, remote areas lack the specialized transportation systems needed to transfer critically ill babies to the healthcare facilities where they can receive the specialized treatment they require. Many families resort to transporting their sick newborn babies without medical support in personal vehicles or on public transportation, or worse, some do not have access to transport and live with the consequences. Our MERU Program outfits an ambulance with the appropriate transportation equipment for newborn babies, and provides guidelines and training to healthcare professionals for the proper transfer of these young lives.

Save-a-Baby Program

Infant and child mortality is almost 2.7 times higher in the western than eastern regions, 2.4 times higher in rural than urban areas, and 2 to 5 times higher in the poorest rural counties than in large cities. (UNICEF China, 2009)

In China, poor, rural families often are unable to afford the required medical care for their newborn child. CMF offers financial assistance to families who face the loss of their newborn child simply because they cannot afford life-saving treatment.

National Neonatal Network

The CMF National Neonatal Network (CMF NNN) is a network that connects CMF’s partner NICU hospitals. As a network of healthcare professionals and hospitals in similar low-resource, rural regions, this network is looking to encourage and support information sharing, standardization, and opportunities for professional development. By connecting health care professionals and their institutions across China, opportunities for learning, growth, innovation and policy change are much greater than if these institutions and individuals were to work independently.

 

Result

  • Improved care for newborn babies
  • Reduced death rate for newborn babies
  • Training for healthcare professionals
  • Equipment and infrastructure for neonatal care
  • A replicable, sustainable health care solution