Why is a Community of Neonatal Nursing Practice important?
Neonatal mortality and morbidity is of great concern especially in low resource settings. Sub-Saharan Africa accounts for the highest neonatal mortality rate in the world at 27 deaths per every 1000 live births (World Health Organization, 2022). Coupled with high mortality the infants born small and sick are at risk for long-term consequences (WHO, 2018). Sustainable Development Goal (SDG) 3 section 2 encourages United Nations (UN) member countries to target reduction of Neonatal Mortality Rate (NMR) to less than 12/1000 live births by the year 2030 (https://Sdg.data.gov./3-2-2/). As most of the mortality is centered around the small and sick newborns, the WHO Every Newborn Action Plan (ENAP) for the low resource countries includes guidelines and standards. Based on the current trajectory none of the Sub-Saharan African countries will make the 2030 NMR goal of less than 12/1000 live births per year. The Every Newborn Action Plan recommendation is to build a competent, empathetic, motivated workforce to help save over 60,000 newborns per year (WHO, 2020).
Human Resource Strategies
In 2020 the WHO published the roadmap on human resource strategies to improve newborn care in health facilities in low-and middle-income countries (WHO, 2020). The proposed strategies included:
National and Subnational Training options to optimize current Human Resources for Health (HRH) cadres and plan specialist roles. Included in this statement is to improve and standardize curricula. Strengthen existing newborn providers through education and skills acquisition. Upgrade existing cadre and provide for specialization.
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National and Subnational Action Plan. This includes standardizing the provision and referral of neonates for care. Developing a plan for retention of neonatal providers. Ensure safe staffing. Allocate finances for neonatal care in the national budget.
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New Cadre of Specialized Neonatal Nurses
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Standardization of neonatal content across curricula.
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Neonatally trained faculty.
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Clinical faculty preceptors.
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Clinical nurse educators.
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Trained staff within neonatal units.
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Recognition of a specialization for neonatal nurses.
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Sufficient nurses to care for the small and sick newborns and their families.
One of the many recommendations was to create and train a new cadre of specialized neonatal nurses. COINN has been engaged in this work for the past few years.
During the work with the different countries seven consistent gaps were noted.