Giving premature babies a chance for a healthy start to life
Jimma, Oromia Region
22-year-old Megersie Alemayehu gave birth to her second child, a baby girl prematurely born at eight months, at Jimma Referral Hospital on new year’s day. Megersie and her baby were admitted to the neonatal intensive care unit (NICU) as the baby was unable to breastfeed, had hypothermia, low birth weight and had acquired an infection while in hospital. The staff nurse in charge of the NICU Sister Atekelt Geremew and Dr. Mekedes Ararso, the paediatrician, explained to her the diagnosis and treatment plan.
A chance to grow up healthy
After 13 days of treatment and close monitoring and support from the NICU staff, the baby’s condition had improved and she was now breastfeeding and breathing comfortably.
Dr Mekedes said the baby will be discharged after completing the course of antibiotics. Under the supervision and support of the NICU ward staff, Megersei’s baby was provided ‘kangaroo mother care’ (KMC) until she reached the age of one month. KMC is an intervention in which mothers put their premature babies skin-to-skin on their chests and wrap them up in a pouch. Skin-to-skin contact with the mother helps to stabilise the babies’ body temperatures, steadies their heart rate and helps with breathing.
“Megersei was oriented on ‘kangaroo mother care’, breastfeeding, immunisation and supplementary feeding. After discharge from the NICU ward, the baby will have weekly follow-ups at the ward,” says Sister Atekelt.
In Ethiopia, saving newborn lives is the Government’s priority as reflected in the Reproductive Health Strategic Plan 2021-2025. The most recent data shows that newborn mortality in the country has stagnated at 30 deaths per 1,000 live births, accounting for 55 per cent of child mortality. To increase access to high impact essential newborn care interventions, the Government in collaboration with its partners has been implementing several facility- and community-based newborn care interventions. They include the essential newborn care package which integrates the newborn corner (NBC) initiative at health center levels, establishment of level II NICUs at all public hospitals across the country, and the community-based newborn care (CBNC), which has recently been integrated into community case management (iCCM).
Since 2010, NICUs have been established in 194 hospitals to take care of babies who are born with low weight or contract an infection. Some 920 nurses, 24 health science college teachers, 192 physicians, and health officers have been trained to appropriately manage sick or ill premature newborns with UNICEF support. To ensure that every zone in the country had high-level care for newborn babies, the Ministry of Health in 2017 invested US$24 million in equipping 80 hospitals with level III NICUs. The Ministry engaged UNICEF to procure, transport, and install the equipment to the health facilities, and to train health workers on the use of the equipment. Since then, 79 of the planned 80 NICUs have been set up. With funding from the US Fund for UNICEF, health workers from 15 NICUs, including the one at Jimma Referral Hospital, were trained on how to operate and use the equipment.
UNICEF is supporting the Government to accelerate and scale up quality newborn care at all three levels of the health system – the community through the community-based newborn care programme; the health centre through establishing “Newborn Corners” to provide essential care immediately after delivery, including birth asphyxia management; and at hospital level by enhancing the knowledge, skills, and practice of NICU staff to provide advanced care for sick newborns. The Government is also establishing learning hospitals for intensive care of critically sick newborn babies through NICUs in each region.
Jimma hospital serves a population of approximately six million people and delivers 4,500 babies every year. At least 1,600 of newborn babies are admitted to the NICU every year. The NICU currently has 25 beds, 10 pediatricians, five neonatal nurses and 17 nurses providing specialized neonatal intensive care for an average of seven newborn babies every day.
Maternal, neonatal and child health services are among the core medical services provided by the hospital since its establishment (1983). However, the hospital has limited skilled human resources, especially neonatologist and nursing staff. The facility does not have a central oxygen supply system to the NICU which is crucial for saving newborns More support is therefore required to build the oxygen supply system and improve record-keeping using digital platforms.
Nevertheless, Sister Atekelt and her colleagues do their utmost to help their young patients.
Megersei is grateful for the treatment her baby received. “Thanks to God, my baby survived,” she says.
