In Ethiopia, VSO has supported seven hospitals to establish fully-equipped neonatal intensive care units and provided training and on-the-job mentoring to ensure they are adequately staffed.
As a result, institutional neonatal death in those hospitals receiving support from VSO decreased by an average of 40%.
Globally, nearly four million babies born each year die within 28 days of birth, with 99% of these deaths occurring in low and middle-income countries. In Ethiopia, this is the outcome for 29 in every 1000 live births, partly because most occur in the home, and where they do take place in a healthcare unit there is a lack of proper specialised care for babies in the first days of life. But things are changing...
No baby born to die
The Neonatal Intensive Care Unit (NICU) at Arbaminch General Hospital, Ethiopia, is a quiet corner amidst the hustle and bustle. Many NICUs are restricted in the space they have, but at Arbaminch the unit occupies a whole corridor. There is an intensive care unit, a Kangaroo Mother Care room where premature babies are moved to after they have left intensive care, a separate room for babies with infections such as meningitis and a mothers’ room where women spend one or two nights for a final monitoring before taking their babies home.
In the centre of the care and treatment rooms is the nurses’ area, a hub of activity and conversation. Manuals line the bookshelves, the walls are covered with information posters and guidelines and data charts display facts and figures underlining the team’s success.
The lasting power of skill-sharing
In each of the NICUs VSO has established, intensive neonatal care instruction is delivered to 40 nurses. VSO volunteers have been critical in establishing the units, then tapering down their involvement so that locally-trained staff can take over full responsibility.
The unit at Arbaminch has been open for a year, having been established with the financial support of VSO, which enabled locally-procured equipment to be bought, as well as the support of two VSO volunteers, Dr Jo Cryer and Dr Andrew Cornish who provided staff training and mentoring.
At Arbaminch, the NICU’s impact is significant: despite being just a year old, it is already an example of best practice and nurses from hospitals in the surrounding area travel here for training.
Head nurse Solomon Tesfaye sums it up:
“These is a high team spirit amongst the NICU staff, a high level of cooperation. There is consistency in the service, consistency in treatment and monitoring by all staff. We are cascading the training to other nurses from the surrounding hospitals. We share resources and we share skills and knowledge.”
It is not just other professionals who the nurses share their skills with – alongside caring for babies on the unit, they also provide advice and coaching for the mothers.
Nurse Firhiwhot Dagne says:
“In the past mothers had to come from the maternal ward to feed their babies but since the NICU has room for mothers the service is comprehensive. We teach about hygiene, breastfeeding and nutrition so they can care for their babies after they are discharged. So the NICU now has the maternal and newborn care in the service.”
Happy, healthy and satisfied mothers
One of the mothers currently in the unit is 18-year-old Haimanot Haile. Her baby boy was born prematurely after five days of labour. Weighing just 3.5lbs when he was born, he spent days in intensive care before moving to the Kangaroo Care room, an area where mothers learn techniques for caring for premature babies.
Speaking about her experience here Haimanot said: “During my two weeks’ stay here in the NICU I observed that the level of care for me as well as for the baby was high. The nurses are good, the care is good, they advised me how to feed the baby and his weight increased. Everything is good. Had my baby and I been at home, the situation would have been worse.”
The team at Arbaminch may already be offering excellent care but they are ambitious for their unit. Over the next year their plan is to expand the unit to allow more mothers and babies to experience the same level of care that Haimanot has received.
Arbaminch is one of seven NICUs that VSO has helped established at hospitals in Ethiopia. They offer best practice care that is having a real impact – the number of babies admitted to NICUs has increased by half, and we have seen a 40% decline in the neonatal mortality rate (the number of babies dying before they reach 28 days old) across the units. As the units become self-sufficient, they become a source of best practice reference and support to more recently established centres.
An independent evaluation found that VSO’s approach to newborn care in Ethiopia is “affordable, well accepted by hospital management and integrated into existing hospital routines, which all help guarantee the project’s sustainability”.
Ethiopia is just one of the countries in which we are working to improve health for the youngest and most vulnerable. Just last year, VSO’s work towards improved healthcare in developing countries reached more than 320,000 babies and children under-5.