149 - A Scoping Review on Delivering Essential Newborn Care in Armed Conflict Settings
Friday, April 22, 2022
6:15 PM – 8:45 PM US MT
Poster Number: 149 Publication Number: 149.112
Ahmed Moutwakil, Stanford University, Denver, CO, United States; Gary L. Darmstadt, Stanford University School of Medicine, BELLEVUE, WA, United States; Brett D. Nelson, Harvard Medical School & Massachusetts General Hospital, Boston, MA, United States; Ribka Amsalu, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Andrew T. Li, Stanford University, Cupertino, CA, United States; Abhinav Kumar, Stanford University, Stanford, CA, United States; Caroline J. Huang, Stanford University, Stanford, CA, United States; Leah E. Balter, Stanford University, Stanford, CA, United States; Amanda Woodward, Stanford University School of Medicine, Stanford, CA, United States; Rishi P. Mediratta, Stanford University School of Medicine, Stanford, CA, United States
Undergraduate Student Stanford University Denver, Colorado, United States
Background: Essential newborn care (ENC) includes thermal care, immediate and exclusive breastfeeding, hygiene, and focuses on the care after birth including neonatal resuscitation and immunizations. Implementation of ENC in countries experiencing armed conflict has been insufficient, yet it is critical to preventing newborn mortality, and for reaching Sustainable Development Goal 3.2 of reducing neonatal mortality to no more than 12/1,000 live births.
Objective: To conduct a scoping review on the implementation of ENC in armed-conflict settings.
Design/Methods: We searched PubMed, Embase, and CINAHL databases, and grey literature sites from the World Health Organization, United Nations, and Reliefweb using terms related to conflict and ENC. We restricted literature published from January 1, 2014 to August 15, 2021. We used the Uppsala Conflict Data Program Georeferenced Event Dataset to identify 37 countries that had a high burden of armed-conflict events between 2014-2020. ENC interventions were categorized into immediate care, resuscitation, postnatal care, and immunizations.
Results: There were 10,137 publications that were identified through database searching. 4,375 duplicates were removed and 5,549 papers were removed at the title and abstract screening stage as irrelevant. 207 full-text studies were screened to assess inclusion eligibility. Among the 138 included studies, 2% (n=3) provided an intervention for neonatal immunization, 38% (n=52) provided postnatal care (including exclusive breastfeeding), 20% (n=28) provided neonatal resuscitation, and 40% (n=56) provided immediate care after birth (including skin-to-skin contact). 60 studies reported outcomes for immediate care after birth, 58 reported outcomes for postnatal care, 30 reported outcomes for neonatal resuscitation, and eight reported outcomes for newborn immunizations. The actors responsible for ENC implementation included mothers (41%, n=56), providers (29%, n=40), birth attendants (24%, n=34), nurses (6%, n=8), and fathers (1%, n=2).Conclusion(s): Literature on ENC implementation in conflict situations focuses on promoting interventions such as exclusive breastfeeding up to six months and skin-to-skin contact with mother/caretaker immediately after birth, primarily through educational programs or training packages for mothers, providers, and birth attendants. However, there is very limited literature on newborn immunization in armed-conflict settings. There is a critical need to deliver ENC interventions in armed-conflict settings. Additional implementation research is needed to understand how to most effectively deliver these interventions.
