Neonatal Nurses' Essential Training and Skills

 Healthcare in Uganda is improving

Uganda has made considerable progress in improving child survival and development.  Between 2011 and 2016 maternal and under-five mortality declined from 438 to 368 per 100,000 and from 90 to 64 per 1,000 live births respectively. Improvements in socio-economic conditions, as well as the availability and utilization of essential health services, contributed to this progress.

Neonatal mortality ( 27 per 1000 live births) still represents 42% of all deaths under 5.

​Despite these positive trends, progress has been slow with neonatal mortality stagnated (at about 27 per 1,000 live births) and is responsible for 42 per cent of all under-five deaths. One-third of child deaths is due to malaria, pneumonia and diarrhoea.

 "Even amongst higher level health facilities in Urganda, availability and quality of maternal and newborn care was low or non-existent." - Studies on newborn care in Uganda (3-6)

Mothers in sub-Saharan Africa are 30 times more likely than their counterparts in the industrialized countries to lose a newborn baby at some point in their lives. In Uganda 39,000 newborn deaths occur each year, accounting for four out of ten deaths before one year of age with over a half of the total newborn deaths occurring mainly in the first 24 hours. ​

1.68 doctors per 10,000 people
12.38 nurse and midwives per 10,000 people
​Before NNETS, there were 0 neonatal nursing programs in Uganda

Neonatal Nurses' Essential Training and Skills

​Program: NNETS Program: (Neonatal Nurses’ Essential Training and Skills)
Mission: Provide state of the art training for neonatal nurses and develop strategies for sustained capacity building of medical manpower that provides care for newborn infants in Uganda.
Method: A hybrid program of neonatal nurse training that includes 40 online sessions over 6 months (March to September 2022) and 5 weeks of on-site mentorship and skills training (September 24 to November 28, 2022) using an experienced faculty of neonatologists and neonatal nurse educators.
Completion: Authentication of training will be done based on strict criteria for attendance, participation, testing and demonstration of skills by the learners.
Participants:      Trainees – 47 nurses and nurse midwives
                             Faculty – Neonatologists (2); Nurses (12), Neonatal Nurse Practitioners (3)
                             Oversight – COINN, Inc and Connecticut Children’s Center for Global Health
Budget: Year 1 - $ 12,000
Funding:
Faculty Time & Effort:    Volunteer - without any remuneration
Support expenses:          Donations from viewers like you, MERUnlimited, Connecticut Children’s
Travel expenses:             Donations from viewers like you
Boarding/ Lodging:         Nakasero Hospital

Timeline

NNETS Curriculum

Part 1: Introduction to Newborns

Lecture 1. Introduction to the NNETS Program
Lecture 2. Conception to Birth: Embryology for Neonatal Caregivers
Lecture 3. Classification of Newborn: Definitions & Terminologies
Lecture 4. Fetal to Neonatal: Anatomy and Physiology of Circulation

​Part 2: Pregnancy and parents

Lecture 5. Individual Pregnancy Factors That Affect The Newborn
​Lecture 6. Skin to Skin: Physiology and Developmental Outcomes
Lecture 7. Parent Education: Infant Safety
Lecture 8. Parent Education: Newborn Care

​Part 3: Common newborn problems

Lecture 9. STABLE: Part 1 - Hypoglycemia
Lecture 10. Intrapartum factors and Neonatal Care
​Lecture 11. Fluid and Electrolytes: Gastrointestinal and Renal 
Lecture 12. Respiratory Problems in Newborns
Lecture 13. STABLE: Part 2 - Thermoregulation

​Part 4: Postnatal transition

Lecture 14. Preparation of Delivery Area: Evaluation and Stabilization
Lecture 15. Neonatal Assessment: During Transition & After Birth
Lecture 16. Neonatal Transitions
Lecture 17. Jaundice In The Newborn

​Part 5: Admission to the NICU

​Part 6: Supporting the Newborn & Family

Lecture 18. NICU Infections and Infection Control
​Lecture 19. General considerations and Prophylaxis on Admission for NICU patients
Lecture 20. Measurements and screening procedures on Admission
Lecture 21. Normal and Abnormal Newborn and Infant Behavior

Lecture 22. Developmentally Supportive Care
Lecture 23. Pain Physiology 
Lecture 24. Developmental adjustment of parents and family members/support person
Lecture 25. Perinatal grief
Lecture 26. Perinatal Infections

​Part 7: Caring for the Newborn

​Part 8: The sick newborn

​Lecture 27. Breastfeeding
Lecture 28. Fundamentals of Human Genetics for the Clinical Nurse
Lecture 29. ​Pain Assessment in the NICU
Lecture 30. STABLE: Part 3 - Respiratory Distress
Lecture 31. Birth Asphyxia and Therapeutic Hypothermia

Lecture 32. STABLE: Part 4 - Laboratory Testing
Lecture 33. Pain management in the NICU
Lecture 34. CPAP Practical points
Lecture 35. Central Lines
Lecture 36. Cardiac Management

Future Directions For Increased Complexity And Sustainability

Partnerships

Please donate to support the growth of Neonatal Nursing in Uganda.

​Click here to donate to NNETS.

​References:
1. https://www.healthynewbornnetwork.org/hnn-content/uploads/BCC.pdf 
2. https://www.healthynewbornnetwork.org/hnn-content/uploads/2021-Countdown2030_Uganda.pdf
3. Namazzi G, Waiswa P, Nakakeeto M, et al. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda. Glob Health Action 2015;8:24271.
4. Waiswa P, Namazzi G, Kerber K, Peterson S. Designing for action: adapting and implementing a community-based newborn care package to affect national change in Uganda. Glob Health Action 2015;8:24250.
5. Waiswa P, Pariyo G, Kallander K, et al. Effect of the Uganda Newborn Study on care-seeking and care practices: a cluster-randomised controlled trial. Glob Health Action 2015;8:24584.
6. Waiswa P. Productive global health research from Africa: it takes more. Int J Public Health 2015;60:755-6.