The concept of the "at-risk newborns" (10)

18 January, 2023

Dear Prof. Narayanan,

Thank you for this sensitization and bringing to the fore once again the challenges in neonatal care in resource- constrained settings. While the concerns and observations raised by the referenced publication are germane and worrisome there is also need to explore the proposal cautiously so that we do not also end up further overburdening the already overburdened healthcare providers with resultant propensity to impact negatively on quality.

On the other hand are other major challenges in my observation, which are the translation of policy to practice, monitoring and maintenance of standards and quality. While all resource- constrained countries continue to face neonatal health care system challenges, the challenges may vary by country and even within countries by regions as shown in one of our publications which evaluated a neonatal health care system in a setting.

It is ones understanding that beginning to firmly and committedly address and target the implementation of short-, mid- and long-term planned interventions to bridge the gaps towards attaining an integrated and comprehensive standard newborn health care system across the continuum of maternal/ perinatal care, primary healthcare/ preventive and community care to the component levels of facility care will very much be a step in the right direction. We are attempting to do this for the setting we assessed through engagement of stake holders.

There is need for settings to assess their health care system as it relates to neonatal health care and services, identifying the strengths and weakness in the context of integration, comprehensiveness and model of levels of facility care.

DR. ABDULKADIR

Chifa Profile : Abdulkadir is a Lecturer and consultant paediatrician/neonatologist, a member of the paediatric association of Nigeria and currently the head of department of paediatrics Ahmadu Bello University/ Teaching Hospital Zaria, Kaduna in northern Nigeria where access and affordability to healthcare remain great challenges. I have worked as consultant to organisations/ programmes including GHAIN, PATHS and CHAI. I am committed to teaching, training and research towards improving child health with particular interest in newborn health. isaburamlaATyahoo.com