Table 3 Tools, technologies, and innovations required for the care of preterm babies.
Priority packages and interventions | Current technology/Tools | Technological innovations required |
|---|---|---|
All babies | Â | Â |
Essential newborn care and extra care forpreterm babies • Thermal care (drying, warming, skin-to-skin and delayed bathing) • Early initiation, exclusive breastfeeding • Hygienic cord and skin care | • Protocols for care, training materials and job aids • Materials for counselling, health education and health promotion • Weighing scales • Cord clamp and scissors, clean birth kit if appropriate • Vitamin K for LBW babies | • Generic communications and counselling toolkit for local adaptation • Generic, modular training kit for adaptation, novel methods e.g. cell phone prompts • Birth kits for frontline workers • Chlorhexidine preparations for application to the umbilical cord • Simplified approaches to identifying preterm babies such as footsize |
Neonatal resuscitation for babies who do not breathe at birth | • Materials for training and job aids • Training manikins • Newborn resuscitation devices (bag-and-mask) • Suction devices • Resuscitation stations with overhead heater • Clock with large face and second hand | • Wide scale novel logistics systems to increase availability of devices for basic resuscitation and training manikins • Additional innovation for resuscitation devices (e.g. upright bag-and-mask, adaptable, lower cost resuscitation stations) |
Preterm babies | Â | Â |
Kangaroo mother care for small babies(birthweight <2,000 g) | • Cloth or wrap for KMC • Baby Hats | Generic communications and counselling toolkit for local adaptation, Innovation to address cultural, professional barriers Generic, modular training kit and job aids for local adaptation |
Care of preterm babies with complications including: • Extra support for feeding preterm and small babies • Case management of babies with signs of infection • Safe oxygen management and supportive care for RDS • Case management of babies with significant jaundice • Managing seizures | • Nasogastric tubes, feeding cups, breast milkpumps • Blood sugar testing sticks • IV fluids including glucose and more accurate giving sets • Syringe drivers • Injection antibiotics, 1 cc syringes/27G needles, preloaded syringes • Oxygen supply/concentrators • Nasal prongs, headboxes, other O2 delivery systems • Pulse oximeters to assess blood oxygen levels with reusable cleanable neonatal probes. • Bilirubinometers (table top and transcutaneous) • Phototherapy lamps and eye shades • Exchange transfusion kits • Hot cots, overhead heaters | Lower-cost and more robust versions of: • Blood sugar testing for babies on low volume samples, heel pricks • Oxygen condensers, including portable options • Pulse oximeters and robust probes, including with alternative power options • Syringe drivers able to take a range of syringes • Bilirubin testing devices including lower cost transcutaneous devices • Haemoglobin and blood grouping, Rhesus Point of Care • Point of care for C-reactive protein/procalcitonin • Apnoea alarm • Phototherapy devices such as portable "bilibed" to provide both phototherapy treatment and heat |
Neonatal intensive care | • Continuous Positive Air Pressure (CPAP) devices with standardised safety features | • Lower-cost robust CPAP equipment with standardised settings • Neonatal intensive care context specific "kits", e.g., district hospital with ongoing support for quality use and for equipment maintenance • Surfactant as more stable, lower cost preparations |