Low-tech, high impact: care for premature neonates in a district hospital in Burundi. A way forward to decrease neonatal mortality

Table 5 NICU and KMC services provided at CURGO in Kabezi District

Neonatology ward^†	KMC ward
Care for sick neonates, regardless of weight and non-sick LBW neonates <1250 g until stabilisation^‡	Care for non-sick, LBW neonates
17 beds, decreased to 12 by February 2012	5 beds shared with mothers
Daytime staff: 2 dedicated nurses; 1 supervisor	Daytime staff: 1 dedicated nurse;
2 lactation assistants (shared);	2 lactation assistants (shared);
1 doctor (shared)	1 doctor (shared)
1 General Pediatrician
Nighttime staff: 2 dedicated nurses; 1 doctor on call (shared)	Nighttime staff: no dedicated staff; nurse from neonatology ward covers the KMC ward; 1 doctor on call (shared)
Protocols	Protocols
Basic warming equipment (3 heating mattress since june 2011)	Skin-to-skin care
Oxygen concentrators	Breastfeeding support Nasogastric tube feeding or alternative feeding techniques if needed
Electric pumps
Intravenous fluids	Bedside monitoring of blood glucose, weight and temperature
Intravenous antibiotics (ampicillin, gentamicin, cefotaxime, cloxacillin, metronidazole)	Oral caffeine (to prevent apnoeaof prematurity)
	Oral ferrous acid folic (to prevent anemia)
Nasogastric tube feeding if needed bedside monitoring of blood glucose, haemoglobin, and oxygen saturation blood transfusion

A laboratory at CURGO performs basic tests (i.e., white blood cell count, malaria microscopy). Culture, bilirubin, C-reactive protein, blood gases and electrolytes are not performed
KMC Kangaroo Mother Care, LBW low birth weight, CURGO Centre d’Urgences Gynéco Obstetricales
^†Services not available in the neonatology ward included blood culture, mechanical ventilation, phototherapy, incubators and on-site surgical and radiology facilities
^‡Neonates with birth weight <1250 g were cared for in the neonatology ward until stabilisation, as they usually required intravenous fluids, intravenous medications and possibly oxygen initially. These were not available in the KMC ward

ISSN: 1756-0500