Linking Preterm Infants with Special Care in rural Bangladesh: Improving Identification and Management of Babies "Born too soon"

The Brigham and Women's Hospital
Organization Location: 
Boston, MA, USA

Complications of preterm birth are the leading cause of neonatal mortality globally. Our aim is to improve early recognition of preterm infants in a setting with 90% home birth and to link these high-risk babies with effective interventions to reduce neonatal morbidity and mortality. For SL@B1 and in collaboration with the World Health Organization, we are currently validating a range of methods to identify preterm infants by first-level health workers. To transition to scale, our next step is "proof-of-concept" of the final preterm assessment. We will develop and validate the final simplified algorithm, which will classify an infant as term ("green zone"), late preterm ("yellow", 34-37 weeks), or early preterm ("pink", 34 weeks), and design a mobile-phone application for clinical triage. Furthermore, using formative research and "human-centered design" we will develop evidence-based packages of preterm care for the facility and home, including interventions for feeding support, jaundice, infection, and hypothermia, with special focus on Kangaroo Mother Care. Empowering communities to co-design solutions will improve service delivery and demand for preterm care. Our approach is novel because first-level health workers in low-resource settings do not routinely assess for prematurity. Our algorithm will be simple, validated in several countries, and supported by a mobile application for clinical decision-making. The integration of this tool into a community designed package of preterm care will result in an innovative, integrated solution to reduce preterm morbidity and mortality in low-income countries.

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