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COVID-19 preparedness-a survey among neonatal care providers in low- and middle-income countries

Klingenberg C 1 , Tembulkar SK 2 , Lavizzari A 3 , Roehr CC 4 , Ehret DEY 5 , Vain NE 6 Show all authors , Mariani GL 7 , Erdeve O 8 , Lara-Diaz VJ 9 , Velaphi S 10 , Cheong HK 11 , Bisht SS 12 , Waheed KAI 13 , Stevenson AG 14 , Al-Kafi N 15 , Roue JM 16 , Barrero-Castillero A 17 , Molloy EJ 18 , Zupancic JAF 19 , Profit J 2 , International Neonatal COVID-19 Consortium

Affiliations 

  • 1 Paediatric Research Group, Department of Clinical Medicine, UiT-The Arctic University of Norway, Tromso, Norway
  • 2 Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
  • 3 Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
  • 4 Newborn Services, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
  • 5 Department of Pediatrics, Robert Larner MD College of Medicine, University of Vermont, Burlington, VT, USA
  • 6 Newborn Medicine, Hospitals Sanatorio Trinidad, Buenos Aires, Argentina
  • 7 Department of Pediatrics, Division of Neonatology, Instituto Universitario Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
  • 8 Department of Pediatrics, Division of Neonatology, Ankara University School of Medicine, Ankara, Turkey
  • 9 Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey, NL, Mexico
  • 10 Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
  • 11 Department of Paediatrics, KPJ Ipoh, KPJ Healthcare Berhad, Kuala Lumpur, Malaysia
  • 12 Neonatal Intensive Care Unit, Swami Dayanand Hospital, Delhi, India
  • 13 The Children's Hospital & The Institute of Child Health, Lahore, Pakistan
  • 14 Department of Paediatrics and Child Health, University of Zimbabwe, Harare, Zimbabwe
  • 15 Division of Neonatology, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
  • 16 Department of Pediatrics, Division of Neonatal and Pediatric Critical Care Medicine, University Hospital of Brest, Brest, France
  • 17 Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
  • 18 Paediatrics, Academic Centre, Children's Hospital Ireland at Tallaght, Trinity College, the University of Dublin, Dublin, Ireland
  • 19 Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA. jzupanci@bidmc.harvard.edu
J Perinatol, 2021 05;41(5):988-997.
PMID: 33850282 DOI: 10.1038/s41372-021-01019-4

Abstract

OBJECTIVE: To evaluate COVID-19 pandemic preparedness, available resources, and guidelines for neonatal care delivery among neonatal health care providers in low- and middle-income countries (LMICs) across all continents.

STUDY DESIGN: Cross-sectional, web-based survey administered between May and June, 2020.

RESULTS: Of 189 invited participants in 69 LMICs, we received 145 (77%) responses from 58 (84%) countries. The pandemic provides significant challenges to neonatal care, particularly in low-income countries. Respondents noted exacerbations of preexisting shortages in staffing, equipment, and isolation capabilities. In Sub-Saharan Africa, 9/35 (26%) respondents noted increased mortality in non-COVID-19-infected infants. Clinical practices on cord clamping, isolation, and breastfeeding varied widely, often not in line with World Health Organization guidelines. Most respondents noted family access restrictions, and limited shared decision-making.

CONCLUSIONS: Many LMICs face an exacerbation of preexisting resource challenges for neonatal care during the pandemic. Variable approaches to care delivery and deviations from guidelines provide opportunities for international collaborative improvement.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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