ASSIST webinar presentation by Dr. Bose

Transcripción

USAID ASSIST Project Webinar
February 3, 2015
Essential Care for Every Baby:
An effective capacity tool for health care
professionals
Moderator: Dr. Jorge Hermida is a medical doctor and an
international expert in continuous quality improvement methods.
He is Regional Director of the USAID ASSIST Project in Latin
America at University Research Co.
Presentor: Dr. Carl Bose is a neonatologist and professor of
pediatrics at the University of North Carolina. He currently serves as a
global health advisor to the American Academy of Pediatrics (AAP).
Over the past two years, Dr. Bose has led a group of international
collaborators in the development of the AAP Essential Care for Every
Baby program, a simplified program to teach essential newborn care
to providers in research-limited environments.
Países de Latinoamérica y el Caribe
Seminario Regional por Internet
Febrero 3, 2015
Cuidados Esenciales para Cada Bebé
Un programa educativo simplificado para proveedores de cuidados
esenciales del recién nacido
Carl Bose, MD
Universidad de Carolina del Norte y la AAP
1
February 3, 2015
Salud neonatal a nivel mundial
 3.8 millones de muertes neonatales (3.2 millones de
mortinatos)
 ~ 3 veces las muertes provocadas por el VIH/SIDA y
la malaria combinados
 > 400 muertes neonatales cada hora
¡La mayoría de estas muertes son prevenibles!
¿Dónde ocurren la mayoría de muertes neonatales?
Oestergaard et al. PLoS Med 2011
2
February 3, 2015
Desigualdades intra-país relativas a la supervivencia infantil
Fuente: Estado de la Niñez de Latinoamérica y el Caribe, UNICEF 2008
3
February 3, 2015
¿Qué ocasiona la muerte neonatal?
¿Qué puede hacerse al respecto?
• KMC
• Alternate feeding techniques
• Thermoregulation
Improved
resuscitation
• Cord care
• Improved hygiene
• Exclusive breastfeeding
4
February 3, 2015
¿Qué se está haciendo?
• Prácticas de cuidados esenciales neonatales (CEN)
recomendadas por la OMS y varias autoridades
de salud
Requisitos para introducir cambios en la
atención de salud:
• Educación para garantizar los conocimientos y
habilidades de los proveedores
• Plan de implementación para trasladar los
conocimientos y habilidades a la práctica
de salud
práctica:
• Plan de implementación que traslade los
5
February 3, 2015
Cuidados Esenciales para Cada Bebé,
un programa de Ayudando a los Bebés a
Sobrevivir
- Paquete de programas educativos para mejorar
la sobrevivencia neonatal
• Currículo basado en la evidencia
• Enfoque educativo compartido – aprendizaje
cooperativo, basado en destrezas, simulación
de tecnología sencilla y alta fidelidad
• Se sugiere práctica continua y mejoramiento
de la calidad
Los programas Ayudando a los Bebés a
Sobrevivir
Improved
resuscitation
• Cord care
6
February 3, 2015
Sobrevivir
Improved
resuscitation
• Cord care
materiales
7
February 3, 2015
Plan de Acción
Rotafolio del Facilitador
8
February 3, 2015
Rotafolio del Facilitador
Guía para Proveedores – Ejercicios Prácticos
9
February 3, 2015
Guía para Proveedores – Ejercicios para desarrollar
habilidades comunicativas
Guía para Proveedores – Revisión y Mejoramiento de
la Calidad
10
February 3, 2015
Guía para Padres
Guía para Padres
11
February 3, 2015
Modelo de pechos – lactancia, extracción, cuidados piel a
piel
Cuidados Esenciales para Cada
Bebé
Pruebas de campo en Kenia
Eldoret - 2013
Pruebas de campo en India
Nueva Delhi, Calcuta,
Hyderabad
2013
12
February 3, 2015
Pruebas de campo adicionales en Uganda e introducción a 10
países de Africa en Addis Abeba, 2014
Academia Americana de Pediatría
Recursos a nivel mundial
• Plataforma en internet para acceder a CECB y otros programas
• Formatos adecuados para descargar/imprimir*
• No hay tarifa de uso
• Los usuarios manifiestan su acuerdo con “las condiciones de
uso”:
 Usado únicamente para educación sin fines de lucro
 No puede ser vendido
• Modificación en función del plan de adaptación local aprobado
• Versión en español disponible ≈ inicios del 2015
• Url: http://www.aap.org/en-us/advocacy-and-policy/aap-healthinitiatives/global/Pages/eceb.aspx
*Las versiones impresas están disponibles a través de la Librería de la AAP o
Laerdal Global Health
13
February 3, 2015
Sobrevivir
Improved
resuscitation
• Cord care
Cuidados Esenciales para bebés pequeños
Simulador de un bebé pretérmino
Peso 1.6 kg
Tamaño y proporciones realistas para un bebé pré-termino
Respalda la capacitación en:
• Posición y acoplamiento adecuado
• Colocación correcta del tubo naso-gástrico
• Alimentación con cuchara, taza y tubo naso-gástrico
• Cuidados continuos piel a piel
14
February 3, 2015
Cuidados Esenciales para bebés pequeños
Cronograma de desarrollo/producción
Notes
Enero/Febrero 2014 Desarrollo de contenidos del
Rotafolio
Marzo
Revisión Delphi
Esquema de contenidos desarrollado
Mayo
Junio
Junio
Revisión OMS
Proceso editorial presencial
Modificación de materiales
Julio/Agosto
Finalización de imágenes,
contenidos
Prueba de campo y revisiones
¿Está confirmada esta fecha?
Elk Grove Village
Cambios necesarios debido a las
revisiones
Uso de materiales modificados con
imágenes
Cambios necesarios debido a la
prueba
Preparación de imágenes finales y
ajustes de formato
Material impreso y archivos pdf
imprimibles disponibles
Septiembre
Octubre-Enero, 2015 Corrección de estilo y
revisiones finales
Abril, 2015
Lanzamiento en Asia del Sur
Revisión de contenidos sin imágenes
de salud
práctica:
• Plan de implementación que traslade los
15
February 3, 2015
Hay trabajo por hacer
~ 2043
Figura 1. Tiempo para que cada región alcance la misma probabildad de sobrevivencia
neonatal en el 2012 que tienen los recién nacidos en países de ingresos elevados, Lawn et
al. Lancet, 2014
Ayudando a los Bebés a Sobrevivir
16
February 3, 2015
Latin American and Caribbean Countries
Regional Webinar
February 3, 2015
Essential Care for Every Baby
A simplified educational program for providers of essential newborn care
Carl Bose, MD
University of North Carolina and the AAP
Global Neonatal Health
 3.8 neonatal deaths (3.2 million stillbirths)
 ~ 3x deaths due to HIV/AIDs and malaria combined
 > 400 neonatal deaths each hour
Most of these deaths are preventable!
17
February 3, 2015
Where do most neonatal deaths occur?
18
February 3, 2015
Intra-country Disparities in Child Survival
From: State of Latin American and Caribbean Children, UNICEF 2008
What causes neonatal death?
19
February 3, 2015
What can be done?
• KMC
Improved
resuscitation
• Cord care
What is being done?
• Essential newborn care (ENC) practices
recommended by the WHO and many health
authorities
Requirements for change in practice:
• Education to insure knowledge and skill of
providers
• Implementation plan to translate knowledge and
skill into practice
20
February 3, 2015
What is being done?
authorities
providers
skill into practice
Essential Care for Every Baby,
a Helping Babies Survive program
- Package of educational programs to improve
neonatal survival
• Evidence-based curricula
• Shared educational approach – skills-based,
cooperative learning, low-tech, high-fidelity
simulation
• Suggested ongoing practice and quality
improvement
21
February 3, 2015
The Helping Babies Survive Programs
Improved
resuscitation
• Cord care
Improved
resuscitation
• Cord care
22
February 3, 2015
materials
Action Plan
23
February 3, 2015
Facilitator Flip Chart
24
February 3, 2015
Provider Guide – Practice Exercises
Provider Guide – Exercises with Communication Skills
25
February 3, 2015
Provider Guide – Review and Quality Improvement
Parent Guide
26
February 3, 2015
Parent Guide
Breast Model – breastfeeding, expression, skin-to-skin care
27
February 3, 2015
Kenya field testing
Eldoret - 2013
India field testing
New Delhi, Kolkata,
Hyderabad
2013
Additional field testing in Uganda and introduction to 10
countries in Africa in Addis Ababa, 2014
28
February 3, 2015
American Academy of Pediatrics
Global Resources
• Web-based platform for access to ECEB and other programs
• Formats suitable for downloading/printing*
• No fee
• Users agree to “terms of use”:
 Used for non-profit education only
 May not be sold
• Modification by approved localization plan
• Spanish version available ≈ early 2015
• Url: http://www.aap.org/en-us/advocacy-and-policy/aaphealth-initiatives/global/Pages/eceb.aspx
*Printed versions available through AAP Bookstore or Laerdal Global Health
Improved
resuscitation
• Cord care
29
February 3, 2015
Essential Care for Small Babies
Preterm simulator
Weight 1.6 kg
Realistic size and proportions for preterm baby
Supports training in
• proper breastfeeding positioning and attachment
• correct nasogastric tube placement
• spoon, cup and nasogastric tube feeding
• continuous skin-to-skin care
Development/production timeline
Notes
January/February
2014
March
Flipchart content development
Content outline developed
Delphi review
Review on content without images
May
June
June
July/August
September
October-January,
2015
April, 2015
WHO review
Editorial face-to-face
Modification of materials
Finalization of images, content
Field testing and revisions
Copyediting and final revisions
Has this date been confirmed?
Elk Grove Village
Necessary edits due to reviews
Using modified materials with images
Necessary edits due to testing
Preparation of final images and
formatting
Printed material and printable pdfs
available
Launch in South Asia
30
February 3, 2015
What is being done?
authorities
providers
skill into practice
There is work to be done
~ 2043
Figure 1 Time for each region to reach the same chance of neonatal survival as in 2012 for
newborn babies in high-income countries, Lawn et al. Lancet, 2014
31
February 3, 2015
Helping Babies Survive
Latin American and Caribbean Countries
Regional Webinar
February 3, 2015
A simplified educational program for providers of essential newborn care
Carl Bose, MD
University of North Carolina and the AAP
32
February 3, 2015
Global Neonatal Health
 3.8 neonatal deaths (3.2 million stillbirths)
 ~ 3x deaths due to HIV/AIDs and malaria combined
 > 400 neonatal deaths each hour
Most of these deaths are preventable!
Where do most neonatal deaths occur?
33
February 3, 2015
Intra-country Disparities in Child Survival
From: State of Latin American and Caribbean Children, UNICEF 2008
34
February 3, 2015
What causes neonatal death?
What can be done?
• KMC
Improved
resuscitation
• Cord care
35
February 3, 2015
What is being done?
authorities
providers
skill into practice
What is being done?
authorities
providers
skill into practice
36
February 3, 2015
Essential Care for Every Baby,
a Helping Babies Survive program
- Package of educational programs to improve
neonatal survival
• Evidence-based curricula
• Shared educational approach – skills-based,
cooperative learning, low-tech, high-fidelity
simulation
• Suggested ongoing practice and quality
improvement
Improved
resuscitation
• Cord care
37
February 3, 2015
Improved
resuscitation
• Cord care
materials
38
February 3, 2015
Action Plan
39
February 3, 2015
Provider Guide – Practice Exercises
40
February 3, 2015
Provider Guide – Exercises with Communication Skills
Provider Guide – Review and Quality Improvement
41
February 3, 2015
Parent Guide
Parent Guide
42
February 3, 2015
Breast Model – breastfeeding, expression, skin-to-skin care
Kenya field testing
Eldoret - 2013
India field testing
New Delhi, Kolkata,
Hyderabad
2013
43
February 3, 2015
Additional field testing in Uganda and introduction to 10
countries in Africa in Addis Ababa, 2014
American Academy of Pediatrics
Global Resources
• Web-based platform for access to ECEB and other programs
• Formats suitable for downloading/printing*
• No fee
• Users agree to “terms of use”:
 Used for non-profit education only
 May not be sold
• Modification by approved localization plan
• Spanish version available ≈ early 2015
• Url: http://www.aap.org/en-us/advocacy-and-policy/aaphealth-initiatives/global/Pages/eceb.aspx
*Printed versions available through AAP Bookstore or Laerdal Global Health
44
February 3, 2015
Improved
resuscitation
• Cord care
Preterm simulator
Weight 1.6 kg
Realistic size and proportions for preterm baby
Supports training in
• proper breastfeeding positioning and attachment
• correct nasogastric tube placement
• spoon, cup and nasogastric tube feeding
• continuous skin-to-skin care
45
February 3, 2015
Development/production timeline
Notes
January/February
2014
March
Flipchart content development
Content outline developed
Delphi review
Review on content without images
May
June
June
July/August
September
October-January,
2015
April, 2015
WHO review
Editorial face-to-face
Modification of materials
Finalization of images, content
Field testing and revisions
Copyediting and final revisions
Has this date been confirmed?
Elk Grove Village
Necessary edits due to reviews
Using modified materials with images
Necessary edits due to testing
Preparation of final images and
formatting
Printed material and printable pdfs
available
Launch in South Asia
What is being done?
authorities
providers
skill into practice
46
February 3, 2015
There is work to be done
~ 2043
Figure 1 Time for each region to reach the same chance of neonatal survival as in 2012 for
newborn babies in high-income countries, Lawn et al. Lancet, 2014
Helping Babies Survive
47
February 3, 2015
Thank you for your participation!
• For more information or to register for future webinars or the
USAID ASSIST project updates please contact Elizabeth Silva
at [email protected]
• Visit the USAID ASSIST Knowledge Portal at
www.usaidassist.org
• Vist the USAID ASSIST’s Salud Materno Infantil Website at
www.maternoinfantil.org
48

ASSIST webinar presentation by Dr. Bose

Transcripción

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