Treatment of neonatal infections: a multi-country analysis of health system bottlenecks and potential solutions

摘要: Around one-third of the world's 2.8 million neonatal deaths are caused by infections. Most these preventable, but occur due to delays in care-seeking, and access effective antibiotic treatment with supportive care. Understanding variation health system bottlenecks scale-up case management infections identifying solutions is essential reduce mortality, also morbidity. A standardised bottleneck analysis tool was applied 12 countries Africa Asia as part development Every Newborn Action Plan. Country workshops involved technical experts complete a survey tool, grade "bottlenecks" hindering scale up maternal-newborn intervention packages. Quantitative qualitative methods were used analyse data, combined literature review, present priority synthesise actions improve newborn For infections, building blocks most frequently graded major or significant bottlenecks, irrespective mortality context geographical region, workforce (11 out countries), community ownership partnership countries). Lack data inform decision making, limited funding increase quality care challenges. Rapid recognition possible serious bacterial infection essential. Inpatient hospital remains first line for In situations where referral not possible, use simplified regimens outpatient non-critically ill young infants has recently been reported large clinical trials; WHO developing guideline treat this group infants. Improving through more investment at all levels critical, addition ensuring dissemination national guidelines. Improved information systems needed track coverage adequately manage drug supply logistics improved outcomes. It important partnership, example involvement groups.