Article type
Abstract
"Background
The Every Newborn Action Plan coverage target 4, ‘Small and sick newborn care (SSNC)’ states that 80% of districts (or equivalent subnational unit) have at least one level-2 neonatal unit for small and sick newborns. Despite this, many countries don’t have a national strategy for scale up of SSNC units and few have the budget to support this. To support countries the World Health Organization (WHO) undertook a novel process to develop normative estimates to guide countries on what they would need to build a level-2 neonatal unit for SSNC.
Objectives
To describe the process of developing normative estimates for SSNC units.
Methods
The team conducted scoping and systematic searches of systematic reviews, primary studies and guidance from literature and countries to establish norms of essential components of level-2 care of SSNC. This included research questions on number of beds per population of live births, time to travel to level-2 facilities, human resources, space required in SSNC units. Qualitative consultation and grey literature was also undertaken.
Results
A ‘hierarchy’ of evidence synthesis was completed for each key research questions. Depending on need a methods scoping review of systematic reviews was completed, followed by subject matter scoping review of systematic reviews and then a systematic review of primary studies. Overall process took 10 months for teams to complete five scoping reviews of systematic reviews and four systematic reviews of primary studies. Findings from the quantitative reviews and qualitative consultation were provided to an expert panel for further consultation.
Conclusion
This process provided important data to aid in the development of normative estimates for for SSNC units. These estimates are still being finalised through expert consensus and aims to be included in the WHO-UNICEF implementation guidance and Emergency Obstetric Care (EmOC) re-visioning. Overall, this process may provide guidance to organisations on how best to develop evidence-based normative estimates when data are lacking.
"
The Every Newborn Action Plan coverage target 4, ‘Small and sick newborn care (SSNC)’ states that 80% of districts (or equivalent subnational unit) have at least one level-2 neonatal unit for small and sick newborns. Despite this, many countries don’t have a national strategy for scale up of SSNC units and few have the budget to support this. To support countries the World Health Organization (WHO) undertook a novel process to develop normative estimates to guide countries on what they would need to build a level-2 neonatal unit for SSNC.
Objectives
To describe the process of developing normative estimates for SSNC units.
Methods
The team conducted scoping and systematic searches of systematic reviews, primary studies and guidance from literature and countries to establish norms of essential components of level-2 care of SSNC. This included research questions on number of beds per population of live births, time to travel to level-2 facilities, human resources, space required in SSNC units. Qualitative consultation and grey literature was also undertaken.
Results
A ‘hierarchy’ of evidence synthesis was completed for each key research questions. Depending on need a methods scoping review of systematic reviews was completed, followed by subject matter scoping review of systematic reviews and then a systematic review of primary studies. Overall process took 10 months for teams to complete five scoping reviews of systematic reviews and four systematic reviews of primary studies. Findings from the quantitative reviews and qualitative consultation were provided to an expert panel for further consultation.
Conclusion
This process provided important data to aid in the development of normative estimates for for SSNC units. These estimates are still being finalised through expert consensus and aims to be included in the WHO-UNICEF implementation guidance and Emergency Obstetric Care (EmOC) re-visioning. Overall, this process may provide guidance to organisations on how best to develop evidence-based normative estimates when data are lacking.
"