Neonatal Care

Overview

The Saint Camille Medical Centre (CMSC) in Ougadougou (Burkina Faso) comprises a maternity ward, where more than 5,000 babies are delivered every year and a Neonatal Care Unit, which hospitalizes ill and premature babies. Country-wide, the CMSC is the only structure, specializing in the care of premature and critical newborns and it is known beyond the borders of Burkina Faso. In fact, patients come also from neighboring countries such as Mali, Mauritania, and Sierra Leone.

The Neonatal Care Unit is skillfully and passionately managed by Agnes Tombiano, the head nurse and it is currently equipped with 43 neonatal cots (all in one room). On average, 2,000 babies are admitted annually.

The basic therapy includes an antibiotic and antifungal treatment for sepsis, administration of gardenal to prevent seizures, of caffeine citrate to treat apneas, and of paracetamol for lowering high temperature. The main strength of that unit is the ability of managing the babies through care protocols, passed on over the years by Dr. Paolo Villani, the Head of the Division of Neonatology of the Mantua Hospital and by his team, that work closely to local staff of CMSC, since 2005.

As reported in Table 1, since 2005 the CMSC registered an increase in the total number of infants hospitalized, a steady increase in survival and a progressive increase of outborn infants. This is because the CMSC has become the reference center for neonatal care in the country.

The percentage of survived patients has decreased from 69,5% in 2012 to 65,5% in 2013. This trend towards an increase in the neonatal mortality rate is confirmed by the latest data available for the first part of 2014 (January-May). During this period were admitted 712 babies, with a survival rate of 61%.

The Neonatal Care Unit mainly provides care to children who were born in other hospitals or at home (over 80% of outborn patients in 2012 and 2013).

A way to raise the survival rate of newborns admitted to CMSC, is to increase the number of inborn babies. This was not possible until recently, since the Centre was not equipped for C-section deliveries. Therefore, difficult deliveries were referred to public hospitals and the eventually troubled baby was then admitted to CMSC days later (if ever). For this reason, the CMSC has decided to equip the maternity ward with a surgical room for trouble deliveries, to be able to ensure immediate intervention and immediate hospitalization of critically ill newborns. The surgical room has been completed and it will be inaugurated in October 2014. A neonatal care area is located next to the surgical room for stabilizing critical newborns, prior to their transfer to the Neonatal Care Unit.

The neonatal care area needs to be equipped as follows:

• Radiant warmers, to be used when a baby is very unstable or extremely premature, with an overhead arm, containing electric heating elements and with a ventilation system;
• Incubators, to protect the babies from noise, drafts, infection and excess handling, also during the transportation from the neonatal care area to the Neonatal Care Unit