Saving newborns in remote areas of Bangladesh

For Poheli Chakma, the joy of being a new mother was interrupted nine days after delivering her first child, a son, on 26 February 2022. Poheli’s baby had been born via C-section at the Rangamati General Hospital – a one-hour boat journey from her village.

While recovering in hospital, Poheli received counselling on newborn care. She learned to watch for the symptoms and danger signs that would signal that her newborn needed treatment at the UNICEF-funded Special Care Newborn Unit (SCANU), which opened on 14 December 2021.

On 7 March, when her baby developed a rash and fever, she rushed him back to the Rangamati General Hospital, and he was admitted to the SCANU. A diagnosis of neonatal sepsis was made quickly, and after five days of treatment, he was well enough to be discharged.

“We received wonderful service from such a well-equipped and clean facility,” said Poheli.

Paediatric consultant Dr Md. Abdul Hai remembered the hospital’s situation before the SCANU. “We used to refer such cases to hospitals in the city, which is not convenient for poor families who live in remote locations,” he said. “We are very happy to have this facility in our hospital now – it really means a lot.”
 

Improving health-care infrastructure for newborns

A decade ago, many hospitals in Bangladesh did not have adequate facilities to manage sick newborns. Seriously sick babies were cared for in ordinary paediatric wards. But without proper safety procedures, case fatalities were high.

Since 2011, UNICEF has been helping the Ministry of Health and Family Welfare develop standard operating procedures while implementing a generic layout design for SCANUs in an expanding number of health facilities.

During the pilot phase, UNICEF helped set up SCANU models in six hospitals and provided essential newborn care equipment such as oxygen concentrators, flowmeters, radiant warmers, phototherapy machines, pulse oximeters, and resuscitators.

By 2021, SCANUs had been established in 37 secondary and tertiary level hospitals covering 34 districts. In 15 additional districts, with UNICEF technical support, the Government replicated the SCANU model using domestic resources.

“UNICEF has procured and supplied all the equipment to establish those 37 SCANUs in Bangladesh and continues to provide maintenance services to those installations to ensure uninterrupted services for newborn babies,” said Dr Shamina Sharmin, Health Specialist, UNICEF Bangladesh.

The UNICEF Supply Catalogue offers a wide range of specialist medical equipment for newborn and child care. UNICEF supports countries in sourcing hospital furniture and equipment, consumables, and high-tech tools to upgrade neonatal intensive care units (NICU) services.

“All medical equipment in SCANUs must function properly in low-resource settings. Where possible, devices are equipped with battery backups and can operate without needing an external supply of oxygen or medical air,” said Abdallah Makhlof, Chief, Health Technology Centre of UNICEF Supply Division.

An assessment of 200 health facilities in Bangladesh revealed that 70 per cent did not have adequate oxygen infrastructure and essential oxygen equipment to treat COVID-19 and non-COVID-19 cases. In response, UNICEF collaborated with the Government to install an oxygen pipeline to all SCANU beds through an additional supply of oxygen concentrators and pulse oximeters.

This article was originally published in the Supply Annual Report 2021