Honduras Changes Practices to Save Lives and Transform the Neonatal Care Experience

Figueroa and her husband were in the hospital's recovery room when Dr. Marly Castellanos approached to inquire about her experience during the delivery. "This time was different from my first delivery because I was with my baby from the very beginning. They brought me to the recovery room, and was already with him," she responds. Figueroa, just hours after giving birth, displayed confidence and appreciated the support of the doctor and nurses who provided details about breastfeeding and other newborn care.

In a challenging context where the neonatal mortality rate accounts for 65% of child deaths, the Pan American Health Organization (PAHO/WHO) works closely with the Ministry of Health of Honduras (SESAL) to enhance care for pregnant women and newborns. This is achieved through capacity building and awareness workshops targeting healthcare personnel.

The improvements demonstrated by the Integrated Santa Bárbara Hospital are the outcome of a series of workshops conducted by the Latin American Center for Perinatology Women and Reproductive Health (CLP/WR) of PAHO/WHO. The goal is to promote the adoption of practices and techniques crucial for the survival and optimal development of newborns, ensuring a more positive and nurturing experience for both infants and their families.

Modules such as essential care for newborns, essential care for preterm or low-weight newborns, and the prevention and management of neonatal asphyxia are key components of these workshops. They follow a train-the-trainer methodology, where trained healthcare personnel replicate knowledge to others, creating a cascading effect to expand the strategy to other healthcare centers and territories in Honduras.

Castellanos, a pediatrician and head of the newborn unit, participated in the initial training and has led five subsequent sessions at the hospital. "These are simple practices that only require a change in attitude but have a crucial impact on the health of babies and the well-being of their mothers," she emphasizes. Among these practices are early attachment, skin-to-skin contact, immediate breastfeeding, proper clothing for newborns, and updated basics of newborn care. Evidence has shown that implementing these practices positively affects the baby's development throughout their life.

“We have witnessed the changes before and after the workshop. Previously, when babies were born, the mother stayed in the delivery room, and the baby was immediately taken to the care unit. Now, early attachment is practiced, and both the mother and the baby are much more relaxed," adds Heidi Madrid, a social service physician at the Santa Bárbara Hospital.

The training sessions use simulators (e.g., plastic dolls replicating realistic anatomical aspects of a neonate's body) to bridge the gap between theory and practice, enhancing skills and strengthening healthcare personnel's knowledge.

For the newborn care team in Santa Barbara, it has been revealing how the implemented changes and acquired practices have substantially changed the experiences of babies and mothers. "Having their baby from the first minute of life has helped mothers feel psychologically well," says Castellanos.

These workshops, part of the project "Improved Health of Women and Adolescent Girls in Situations of Vulnerability", supported by the Government of Canada, are also implemented in Bolivia, Ecuador, Guyana, and Peru.

"These workshops in Honduras are part of a regional strategy aiming to reduce neonatal mortality in the Americas, particularly in areas of higher vulnerability with greater inequalities and higher mortality rates," says Dr. Pablo Durán, PAHO's Regional Perinatal Health Advisor. He emphasizes that “the training promotes evidence-based practices that save lives and ensure positive attachment and care experiences. Care should be family-centered."

In Honduras, six health regions were prioritized: Santa Bárbara, Cortés, Francisco Morazán, Intibucá, Atlántida, and Gracias a Dios. The goal is to continue scaling the positive effects of these training sessions throughout the country. "The primary healthcare-focused approach, including health personnel training, teleconsultation, information systems, and the use of perinatal technologies, has facilitated the development of good practices related to essential newborn care, paving the way for continuous improvement in healthcare quality in the country," comments Dr.Amalia Ayala, project leader and health services advisor at PAHO Honduras.

The work carried out by PAHO under this project requires ongoing effort and joint commitment with national authorities, local governments, healthcare personnel, and communities. "Working towards replicating this experience throughout the country and the region, benefiting populations in greater vulnerability, is one of our main objectives to close gaps and ensure safe and comfortable experiences for women", concludes Ayala.