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Small and sick newborn care during the COVID-19 pandemic: global survey and thematic analysis of healthcare providers’ voices and experiences

Abstract:
INTRODUCTION: The COVID-19 pandemic is disrupting health systems globally. Maternity care disruptions have been surveyed, but not those related to vulnerable small newborns. We aimed to survey reported disruptions to small and sick newborn care worldwide and undertake thematic analysis of healthcare providers' experiences and proposed mitigation strategies. METHODS: Using a widely disseminated online survey in three languages, we reached out to neonatal healthcare providers. We collected data on COVID-19 preparedness, effects on health personnel and on newborn care services, including kangaroo mother care (KMC), as well as disruptors and solutions. RESULTS: We analysed 1120 responses from 62 countries, mainly low and middle-income countries (LMICs). Preparedness for COVID-19 was suboptimal in terms of guidelines and availability of personal protective equipment. One-third reported routine testing of all pregnant women, but 13% had no testing capacity at all. More than 85% of health personnel feared for their own health and 89% had increased stress. Newborn care practices were disrupted both due to reduced care-seeking and a compromised workforce. More than half reported that evidence-based interventions such as KMC were discontinued or discouraged. Separation of the mother-baby dyad was reported for both COVID-positive mothers (50%) and those with unknown status (16%). Follow-up care was disrupted primarily due to families' fear of visiting hospitals (~73%). CONCLUSION: Newborn care providers are stressed and there is lack clarity and guidelines regarding care of small newborns during the pandemic. There is an urgent need to protect life-saving interventions, such as KMC, threatened by the pandemic, and to be ready to recover and build back better
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1136/bmjgh-2020-004347

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Role:
Author
ORCID:
0000-0002-9721-0308
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Role:
Author
ORCID:
0000-0002-2650-443X
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Role:
Author
ORCID:
0000-0003-3457-8452
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Institution:
University of Oxford
Role:
Author
ORCID:
0000-0002-0958-0713


Publisher:
BMJ Publishing Group
Journal:
BMJ Global Health More from this journal
Volume:
6
Issue:
3
Pages:
e004347-e004347
Publication date:
2021-03-14
Acceptance date:
2020-12-09
DOI:
EISSN:
2059-7908
ISSN:
2059-7908


Language:
English
Keywords:
Pubs id:
1168223
Local pid:
pubs:1168223
Source identifiers:
W3124017631
Deposit date:
2026-02-14
ARK identifier:
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