Introduction
In the realm of neonatal care, particularly in low- and middle-income countries (LMICs), the challenges are manifold. With an annual toll of approximately 2.3 million neonatal deaths globally, there is an urgent need to enhance the quality of care for small and sick newborns. The recent research article, "Neonatal inpatient dataset for small and sick newborn care in low- and middle-income countries: systematic development and multi-country operationalisation with NEST360," offers a data-driven approach to addressing these challenges.
Understanding the NEST360 Neonatal Inpatient Dataset
The NEST360 initiative has developed a comprehensive neonatal inpatient dataset (NID) to improve the quality of care in neonatal units across Malawi, Kenya, Tanzania, and Nigeria. This dataset is a part of a broader effort to meet the Every Newborn Action Plan (ENAP) targets, which aim to reduce neonatal mortality rates by 2025.
The NID comprises 60 core variables organized into six categories:
- Birth details and maternal history
- Admission details and identifiers
- Clinical complications and observations
- Interventions and investigations
- Discharge outcomes
- Diagnosis and cause of death
These categories were meticulously designed to facilitate real-time quality improvement and data-driven decision-making at both facility and national levels.
Implementation and Impact
The NID has been operationalized in 69 neonatal units across four African countries, linking to a facility-level quality improvement dashboard. This integration allows for real-time data usage, enabling healthcare providers to make informed decisions swiftly. The dashboard provides insights into admissions, mortality, clinical care quality, and health system inputs, thus promoting a holistic approach to neonatal care.
Data collected through the NID is not only used for immediate clinical decision-making but also serves as a valuable resource for national health systems. By integrating with existing health information systems like DHIS2, the NID facilitates comprehensive analyses that can inform policy and strategic planning at the national level.
Lessons Learned and Future Directions
The implementation of the NID has provided several key insights:
- Co-design and Collaboration: Engaging stakeholders from the outset ensures that the dataset is tailored to the specific needs of each country, enhancing its utility and acceptance.
- Data Quality and Timeliness: Employing dedicated data collectors and using electronic data entry systems significantly improve data quality and timeliness.
- Scalability and Sustainability: Integrating the NID with national health information systems ensures its sustainability and scalability, allowing for broader adoption across different regions.
Moving forward, there is potential to expand the NID to include additional modules, such as follow-up care for at-risk newborns and retinopathy of prematurity. These enhancements will further strengthen the dataset's ability to support comprehensive neonatal care.
Conclusion
The NEST360 Neonatal Inpatient Dataset represents a significant advancement in neonatal care, particularly in LMICs. By leveraging data-driven insights, healthcare providers can improve the quality of care for small and sick newborns, ultimately reducing neonatal mortality rates. As we continue to refine and expand this tool, collaboration and feedback from practitioners will be crucial to its success.
To read the original research paper, please follow this link: Neonatal inpatient dataset for small and sick newborn care in low- and middle-income countries: systematic development and multi-country operationalisation with NEST360.
