Montevideo, 23 August 2024. On 20 August, the webinar Data for action across LAC for neonatal quality and equity of care took place.
This activity is part of a series of seminars on application tools for the care of small and sick newborns being promoted by NEST360 and Unicef, with the support of the Pan American Health Organization (PAHO) and the Healthy Newborn Network (HNN).
PAHO Perinatal Health Advisor and representative of the Neonatal Alliance, Pablo Durán, presented on neonatal mortality trends in LAC and the relevance of information systems.
Durán explained that neonatal mortality represents more than 50% of all deaths of children under 5 years of age, and its main causes are: prematurity, congenital defects, intrapartum events and sepsis.
Approximately 10 million births and 100,000 neonatal deaths occur annually in LAC. In addition, there are 1.2 million premature births, which in many cases result in moderate or severe complications.
In the region, there are various frameworks that help identify opportunities for improvement and guide actions to address these issues. Among these, the PAHO advisor highlighted the Plan of Action for Women's, Children's and Adolescents' Health 2018-2030, which points out, among others, the need for strategic information to monitor health status and inequities and to inform the development of transformative approaches in health interventions.
In terms of trends, Durán noted that there has been a slowdown in the reduction of neonatal mortality since 2005, mainly affecting countries with lower levels of socio-economic development.
‘The Perinatal Information System (SIP) is a tool for surveillance, monitoring and evaluation. Having updated and reliable data is essential for decision-making and providing accurate answers," he noted.
In addition, he said that the SIP not only includes the registration of newborns but also the registration of situations such as prematurity, illness or low birth weight, and there are specific modules for congenital defects and sepsis.
This system also allows for the analysis of inequalities and adapts to the needs of the countries.
Argentina: Importance of data registration in transforming newborn care
The coordinator of the Neonatology Area of the Perinatal and Child Health Directorate of the Argentinean Ministry of Health, Patricia Fernández, referred to the importance of recording data to ‘identify patterns, trends and define areas to work on’.
The specialist pointed out that the correct and systematic recording of data makes it possible to: contribute to the continuous improvement of the quality of care; identify risk factors; monitor child health in the long term; evaluate the effectiveness of interventions; identify areas for improvement; plan health services; make decisions based on evidence; facilitate research and the generation of knowledge; and compare results at national and international level.
In Argentina, the use of the SIP Plus, which is the online version of the SIP, is spreading. In addition to the use of the traditional Perinatal SIP, the country uses the Neonatal SIP (which is in the process of being updated) and is moving towards a Follow-up SIP.
Fernandez mentioned some challenges such as the need for more human and technological resources, the need for training and the resistance to change that sometimes occurs.
She also referred to the next steps in the implementation of the SIP and highlighted the ‘use of information for action’. Expectations are: to prevent disabilities associated with prematurity; to organise risk surveillance by articulating levels of care; to ensure timely, family and community-centred interventions; and to manage access to special health care needs.
Peru: Registry for monitoring response to sepsis and infections
Zenobia E. Quispe, coordinator of the Epidemiological Surveillance of Healthcare-Associated Infections (IAAS, for its acronym in Spanish) of the Peruvian Ministry of Health, explained how registration systems are used to monitor the response to sepsis and infections associated with newborn health care in the country.
In Peru, there is a universal and mandatory IAAS surveillance network that operates at three levels: national, regional and local. In general, nurses are responsible for identifying cases of IAAS and the population at risk, keeping records, consolidating data, analyzing and reporting them.
Among the advantages of the surveillance network Quispe highlighted that it allows establishing baselines or points of comparison to evaluate incidence rates; facilitates the timely detection of epidemic outbreaks; allows informing, educating and reinforcing good practices; contributes to raising awareness among health personnel about infection prevention practices; favors the identification of high-risk practices for IASS.
Finally, she said, “Registration systems are valuable tools for infection prevention and control. IASS surveillance is the keystone for decision making in prevention and control, as well as for the timely identification and control of outbreaks”.
Nicaragua: Progress in the registry for the surveillance of prenatal and postnatal anomalies through the SIP
María Auxiliadora Gadea, National Coordinator for Children at the Nicaraguan Ministry of Health, spoke about the evolution of the SIP in Nicaragua since its adoption in 1990. The country is currently using the basic SIP with Near Miss, SIP A, SIP Congenital Anomalies and SIP Neonatal.
For its incorporation and development, the coordinator highlighted the importance of having regulatory frameworks which, in the case of Nicaragua ‘have been a robust support for the implementation of the SIP’.
Gadea showed the prenatal and postnatal anomalies form and expressed that it is of utmost importance to have this information, as congenital anomalies are the leading cause of neonatal mortality in the country.
It should be noted that this system has been incorporated into Nicaragua's Family and Community Health Model (MOSAFC), favouring timely and coordinated work in the communities.
Among the advantages of using the SIP, Gadea highlighted that it allows for the timely identification of risk factors such as anomalies, and has an impact on improving the quality of maternal and neonatal care; it allows for the characterisation of the population and analysis of causes of morbidity and mortality; it provides real-time information for timely decision-making for improvement; it enables the evaluation of the performance of care services through quality; it provides information based on scientific evidence that allows studies to be carried out; it promotes compliance with standards; and it facilitates communication between the primary and hospital levels of care.
To conclude, Gadea pointed out that political will and involvement is essential to develop and enhance the SIP as a tool for data collection and analysis.
In sum, the presentations that took place during the seminar made clear the importance of information systems as fundamental tools to improve the quality of neonatal care. Reliable data enables informed decision-making, reduces inequities and ensures timely interventions that benefit newborns and their families.
