RESUMO
Globally, the burden of deaths and illness is still unacceptably high at the day of birth. Annually, approximately 300.000 women die related to childbirth, 2.7 million babies die within their first month of life, and 2.6 million babies are stillborn. Many of these fatalities could be avoided by basic, but prompt care, if birth attendants around the world had the necessary skills and competencies to manage life-threatening complications around the time of birth. Thus, the innovative Helping Babies Survive (HBS) and Helping Mothers Survive (HMS) programs emerged to meet the need for more practical, low-cost, and low-tech simulation-based training. This paper provides users of HBS and HMS programs a 10-point list of key implementation steps to create sustained impact, leading to increased survival of mothers and babies. The list evolved through an Utstein consensus process, involving a broad spectrum of international experts within the field, and can be used as a means to guide processes in low-resourced countries. Successful implementation of HBS and HMS training programs require country-led commitment, readiness, and follow-up to create local accountability and ownership. Each country has to identify its own gaps and define realistic service delivery standards and patient outcome goals depending on available financial resources for dissemination and sustainment.
Assuntos
Parto Obstétrico/educação , Mortalidade Infantil , Tocologia/educação , Natimorto/epidemiologia , Parto Obstétrico/mortalidade , Países em Desenvolvimento , Feminino , Humanos , Lactente , Recém-Nascido , Mães , Parto , GravidezAssuntos
Reanimação Cardiopulmonar/normas , Serviços Médicos de Emergência/normas , Parada Cardíaca/terapia , Manuseio das Vias Aéreas/métodos , Manuseio das Vias Aéreas/normas , Dano Encefálico Crônico/epidemiologia , Dano Encefálico Crônico/etiologia , Dano Encefálico Crônico/prevenção & controle , Reanimação Cardiopulmonar/educação , Reanimação Cardiopulmonar/métodos , Salas de Parto/normas , Parto Obstétrico/métodos , Emergências , Serviços Médicos de Emergência/métodos , Medicina Baseada em Evidências , Feminino , Parada Cardíaca/tratamento farmacológico , Massagem Cardíaca/efeitos adversos , Massagem Cardíaca/métodos , Massagem Cardíaca/normas , Humanos , Incubadoras para Lactentes , Cuidado do Lactente/métodos , Cuidado do Lactente/normas , Recém-Nascido , Recém-Nascido Prematuro , Doenças do Prematuro/fisiopatologia , Doenças do Prematuro/terapia , Monitorização Fisiológica/métodos , Monitorização Fisiológica/normas , Estudos Observacionais como Assunto , Gravidez , Complicações na Gravidez , Respiração Artificial/métodos , Respiração Artificial/normas , Taxa de SobrevidaRESUMO
Nutrients exert unique regulatory effects in the perinatal period that mold the developing immune system. The interactions of micronutrients and microbial and environmental antigens condition the post-birth maturation of the immune system, influencing reactions to allergens, fostering tolerance towards the emerging gastrointestinal flora and ingested antigens, and defining patterns of host defense against potential pathogens. The shared molecular structures that are present on microbes or certain plants, but not expressed by human cells, are recognized by neonatal innate immune receptors. Exposure to these activators in the environment through dietary intake in early life can modify the immune response to allergens and prime the adaptive immune response towards pathogens that express the corresponding molecular structures.