Global Newborn Health: Lessons from Facilitating Quality Improvement in Basic Resuscitation in Low- and Middle-Income Countries

Global Health Seminar Series 2023-2024

Wednesday, April 17, 2024 / 12:00 pm – 1:00 pm

Poor newborn outcomes are no longer only dependent on inadequate access to care but are often due to poor quality of care. International agencies such as the World Health Organization are increasingly focused on promoting quality of care globally. However, there are many challenges to improving newborn survival through quality improvement. Birth asphyxia (failure to establish breathing), contributes to nearly a quarter of neonatal deaths. Most babies at risk for asphyxia respond to basic resuscitation, but implementing resuscitation relies on rapid risk assessment using the Apgar Score, which is currently not included in management in many global settings. This presentation describes challenges in promoting quality improvement in two hospitals in Ghana, while suggesting remedies and highlighting the potential value of expanding use of the Apgar Score.

Indira Narayanan is an adjunct professor in neonatology and a consultant in Global Newborn Health at Georgetown University. She has over 45 years of experience in newborn care, initially as a clinician in charge of neonatal intensive care units in India and for the past 24 years in the area of Global Newborn Health in the U.S. She worked as a Team Leader in Global Newborn Care in USAID Programs, and in projects organized by UNICEF, WHO, and international organizations, such as PATH, MSH, and Save the Children. Her programmatic experiences have ranged from facilitating pilot implementation, promoting sustainability, and developing national level strategies in 19 countries in Asia, Africa, and Latin America. Her seminal study on breast milk proved for the first time in world literature the clinical implications of the anti-infective factors in human milk (Lancet 1984).

Dr. Indira Narayanan, MBBS, MD, FNNF, FIAP, FNAMS
Georgetown University