Care of the infant and newborn in Malawi (2017) : the COIN Course - Participants Manual

Abstract

The majority of deaths in neonates and young infants can be prevented with low-cost interventions. It has been estimated that we can reduce up to half of all preventable neonatal deaths, with optimal treatment of neonatal illness. In addition to providing care to newborns at birth, a district health facility also receives sick young infants with diverse clinical presentations, some of whom are extremely sick and need emergency treatments. This course will deal with the care of newborns at birth, the first few days of life and sick young infants who are likely to be encountered in a secondary level health facility. There is a lot of overlap between the clinical presentation and the management of conditions in the neonate and the young infant (defined as an infant less than two months of age). In this manual, when referring to both age groups we will discuss as the Neonate and Young Infant (NYI). The young infant who requires resuscitation may well be a neonate who is only a few days old. The approach to initial resuscitation is very slightly different between the neonate and young infant but the skills required are the same and you will practice these during this course. This manual is for the candidate participating in a training on the Care of the Young Infant and Newborn (COIN). This manual is supported by course material including lectures, videos, drills and scenarios. The training is targeted at nurses, clinicians and medical assistants and will be useful for any nursing and clinical staff looking after newborns and young infants in health facilities. The course provides an evidence base where available and usual practice where there is no evidence. We have tried to strike the right balance between the best and most pragmatic practice for our setting as well as incorporated current evidence. There are grey areas in medicine and despite the latest evidence, there may be no right answer. In this course, we have tried to give the candidate a clear direction in a given situation. However, these are guidelines and if there is a good clinical reason to deviate from them, then that is also good clinical practice. If unclear about the management of an NYI, the next step is to consult a colleague at your facility or to discuss with colleagues from your central hospital. At the back of the manual, there are wall charts or job aids – intended for printing and placing in all clinical areas where NYI are cared for including the clinic, the ward and the nursery. On the last day of the COIN course, there is an examination which includes an MCQ to test knowledge, a competency based assessment which tests skills. Attitude includes attendance and participation and this is assessed throughout the course.