Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya
Neonatal deaths contribute a growing proportion to childhood mortality, and increasing access to inpatient newborn care has been identified as a potential driver of improvements in child health. However, previous work by this research team identified substantial gaps in the coverage and standardisat...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019-03-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/4/2/e001195.full |
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| author | David Gathara Mike English Georgina A V Murphy Claire Marriott Keene Nancy Abuya |
| author_facet | David Gathara Mike English Georgina A V Murphy Claire Marriott Keene Nancy Abuya |
| author_sort | David Gathara |
| collection | DOAJ |
| description | Neonatal deaths contribute a growing proportion to childhood mortality, and increasing access to inpatient newborn care has been identified as a potential driver of improvements in child health. However, previous work by this research team identified substantial gaps in the coverage and standardisation of inpatient newborn care in Nairobi City County, Kenya. To address the issue in this particular setting, we sought to draft recommendations on the categorisation of neonatal inpatient services through a process of policy review, evidence collation and examination of guidance in other countries. This work supported discussions by a panel of local experts representing a diverse set of stakeholders, who focused on formulating pragmatic, context-relevant guidance. Experts in the discussions rapidly agreed on overarching priorities guiding their decision-making, and that three categories of inpatient neonatal care (standard, intermediate and intensive care) were appropriate. Through a modified nominal group technique, they achieved consensus on allocating 36 of the 38 proposed services to these categories and made linked recommendations on minimum healthcare worker requirements (skill mix and staff numbers). This process was embedded in the local context where the need had been identified, and required only modest resources to produce recommendations on the categorisation of newborn inpatient care that the experts agreed could be relevant in other Kenyan settings. Recommendations prioritised the strengthening of existing facilities linked to a need to develop effective referral systems. In particular, expansion of access to the standard category of inpatient neonatal care was recommended. The process and the agreed categorisations could inform discussion in other low-resource settings seeking to address unmet needs for inpatient neonatal care. |
| format | Article |
| id | doaj-art-e193a569de064a0b9c75cdc4bcdb75fd |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2019-03-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-e193a569de064a0b9c75cdc4bcdb75fd2025-08-20T02:35:42ZengBMJ Publishing GroupBMJ Global Health2059-79082019-03-014210.1136/bmjgh-2018-001195Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in KenyaDavid Gathara0Mike English1Georgina A V Murphy2Claire Marriott Keene3Nancy Abuya43 MARCH Centre, London School of Hygiene and Tropical Medicine, London, UKHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaNuffield Department of Medicine, University of Oxford, Oxford, UKCentre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UKNairobi City County, Nairobi, KenyaNeonatal deaths contribute a growing proportion to childhood mortality, and increasing access to inpatient newborn care has been identified as a potential driver of improvements in child health. However, previous work by this research team identified substantial gaps in the coverage and standardisation of inpatient newborn care in Nairobi City County, Kenya. To address the issue in this particular setting, we sought to draft recommendations on the categorisation of neonatal inpatient services through a process of policy review, evidence collation and examination of guidance in other countries. This work supported discussions by a panel of local experts representing a diverse set of stakeholders, who focused on formulating pragmatic, context-relevant guidance. Experts in the discussions rapidly agreed on overarching priorities guiding their decision-making, and that three categories of inpatient neonatal care (standard, intermediate and intensive care) were appropriate. Through a modified nominal group technique, they achieved consensus on allocating 36 of the 38 proposed services to these categories and made linked recommendations on minimum healthcare worker requirements (skill mix and staff numbers). This process was embedded in the local context where the need had been identified, and required only modest resources to produce recommendations on the categorisation of newborn inpatient care that the experts agreed could be relevant in other Kenyan settings. Recommendations prioritised the strengthening of existing facilities linked to a need to develop effective referral systems. In particular, expansion of access to the standard category of inpatient neonatal care was recommended. The process and the agreed categorisations could inform discussion in other low-resource settings seeking to address unmet needs for inpatient neonatal care.https://gh.bmj.com/content/4/2/e001195.full |
| spellingShingle | David Gathara Mike English Georgina A V Murphy Claire Marriott Keene Nancy Abuya Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya BMJ Global Health |
| title | Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya |
| title_full | Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya |
| title_fullStr | Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya |
| title_full_unstemmed | Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya |
| title_short | Developing recommendations for neonatal inpatient care service categories: reflections from the research, policy and practice interface in Kenya |
| title_sort | developing recommendations for neonatal inpatient care service categories reflections from the research policy and practice interface in kenya |
| url | https://gh.bmj.com/content/4/2/e001195.full |
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