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1.
Hum Resour Health ; 18(1): 75, 2020 10 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028347

RESUMO

Peripartum deaths remain significantly high in low- and middle-income countries, including Kenya. The COVID-19 pandemic has disrupted essential services, which could lead to an increase in maternal and neonatal mortality and morbidity. Furthermore, the lockdowns, curfews, and increased risk for contracting COVID-19 may affect how women access health facilities. SARS-CoV-2 is a novel coronavirus that requires a community-centred response, not just hospital-based interventions. In this prolonged health crisis, pregnant women deserve a safe and humanised birth that prioritises the physical and emotional safety of the mother and the baby. There is an urgent need for innovative strategies to prevent the deterioration of maternal and child outcomes in an already strained health system. We propose strengthening community-based midwifery to avoid unnecessary movements, decrease the burden on hospitals, and minimise the risk of COVID-19 infection among women and their newborns.


Assuntos
Infecções por Coronavirus/epidemiologia , Cuidado do Lactente/organização & administração , Serviços de Saúde Materna/organização & administração , Tocologia , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Betacoronavirus , Feminino , Acesso aos Serviços de Saúde , Humanos , Lactente , Mortalidade Infantil , Recém-Nascido , Quênia/epidemiologia , Pandemias , Gravidez
2.
Hu Li Za Zhi ; 67(5): 82-88, 2020 Oct.
Artigo em Chinês | MEDLINE | ID: mdl-32978769

RESUMO

Retinopathy of prematurity (ROP) is a disorder affecting the development of retinal blood vessels in preterm infants. Eye screening examinations are important to the early detection and treatment of ROP. However, several studies have associated eye examinations with pain, stress, and negative physiological effects. Developmental care has been provided as part of neonatal care in recent decades, and some studies indicate that this care positively affects pain scores, stress response, and recovery time during ROP eye screenings. In this article, five elements of developmental care that are applicable for preterm infants undergoing eye examinations for ROP are highlighted and described. These five elements include environmental modifications (e.g., provide a quite environment and dim room lighting), positioning (e.g., offer a nest or positing support and promote the infant to achieve neuromotor development), oxygen delivery (provide adequate oxygen support according to clinical conditions), approach and interaction (e.g., talk softly to infants and gently touch them before the eye examination), and cue-based individual care (e.g., soothe infants, give them a short break or soother based on observations of needs and cue-based behavior). Effectively addressing these five elements may minimize the pain, stress, and energy consumption during ROP eye screenings and provide individualized care that is comfortable, supportive, and promotes the healthy development of preterm infants.


Assuntos
Cuidado do Lactente/métodos , Exame Físico/métodos , Retinopatia da Prematuridade/diagnóstico , Desenvolvimento Infantil , Humanos , Recém-Nascido , Recém-Nascido Prematuro
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47783

RESUMO

Aleitamento materno na atenção neonatal e infantil de alta complexidade: um estudo de coorte, foi tema da tese de doutorado do Banco de Leite Humano (BLH) do Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF/Fiocruz). O estudo teve o objetivo de investigar a prevalência, duração mediana, os padrões e determinantes do aleitamento materno nos primeiros seis meses de vida de crianças nascidas ou transferidas (com até 7 dias de vida) para o IFF/Fiocruz, instituição de referência nacional para alto risco fetal, neonatal e infantil.


Assuntos
Aleitamento Materno , Terapia Intensiva Neonatal , Estudos de Coortes , Cuidado do Lactente
6.
Lancet Child Adolesc Health ; 4(10): 750-760, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32735783

RESUMO

Background Increasing numbers of neonates are undergoing painful procedures in low-income and middle-income countries, with adequate analgesia seldom used. In collaboration with a multi-disciplinary team in Kenya, we aimed to establish the first evidence-based guidelines for the management of routine procedure-related neonatal pain that consider low-resource hospital settings. METHODS: We did a systematic review by searching MEDLINE, Embase, CINAHL, and CENTRAL databases for studies published from Jan 1, 1953, to March 31, 2019. We included data from randomised controlled trials using heart rate, oxygen saturation (SpO2), premature infant pain profile (PIPP) score, neonatal infant pain scale (NIPS) score, neonatal facial coding system score, and douleur aiguë du nouveau-né scale score as pain outcome measures. We excluded studies in which neonates were undergoing circumcision or were intubated, studies from which data were unextractable, or when pain was scored by non-trained individuals. We did a narrative synthesis of all studies, and meta-analysis when data were available from multiple studies comparing the same analgesics and controls and using the same outcome measures. 17 Kenyan health-care professionals formed our clinical guideline development panel, and we used the Grading of Recommendations, Assessment, Development and Evaluation framework and the panel's knowledge of the local health-care context to guide the guideline development process. This study is registered with PROSPERO, CRD42019126620. FINDINGS: Of 2782 studies assessed for eligibility, data from 149 (5%) were analysed, with 80 (3%) of these further contributing to our meta-analysis. We found a high level of certainty for the superiority of breastfeeding over placebo or no intervention (standardised mean differences [SMDs] were -1·40 [95% CI -1·96 to -0·84] in PIPP score and -2·20 [-2·91 to -1·48] in NIPS score), and the superiority of oral sugar solutions over placebo or no intervention (SMDs were -0·38 [-0·61 to -0·16] in heart rate and 0·23 [0·04 to 0·42] in SpO2). We found a moderate level of certainty for the superiority for expressed breastmilk over placebo or no intervention (SMDs were -0·46 [95% CI -0·87 to -0·05] in heart rate and 0·48 [0·20 to 0·75] in SpO2). Therefore, the panel recommended that breastfeeding should be given as first-line analgesic treatment, initiated at least 2 min pre-procedure. Given contextual factors, for neonates who are unable to breastfeed, 1-2 mL of expressed breastmilk should be given as first-line analgesic, or 1-2 mL of oral sugar (≥10% concentration) as second-line analgesic. The panel also recommended parental presence during procedures with adjunctive provision of skin-to-skin care, or non-nutritive sucking when possible. INTERPRETATION: We have generated Kenya's first neonatal analgesic guidelines for routine procedures, which have been adopted by the Kenyan Ministry of Health, and have shown a framework for clinical guideline development that is applicable to other low-income and middle-income health-care settings. FUNDING: Wellcome Trust Research Programme, and the Africa-Oxford Initiative.


Assuntos
Cuidado do Lactente/métodos , Método Canguru/métodos , Manejo da Dor/métodos , Dor/prevenção & controle , Analgésicos/uso terapêutico , Feminino , Humanos , Lactente , Recém-Nascido , Quênia , Masculino , Dor/tratamento farmacológico , Flebotomia/efeitos adversos , Guias de Prática Clínica como Assunto , Punções/efeitos adversos
7.
Artigo em Inglês | MEDLINE | ID: mdl-32784938

RESUMO

AIMS: To examine whether compensatory health beliefs (CHB) on breastfeeding vary as a function of breastfeeding status among mothers of infants. METHODS: Participants included 773 women aged 18 and older (M = 32.8) who gave birth in the last two years; 445 were breastfeeding exclusively, 165 were breastfeeding partially, and 163 were not breastfeeding. They responded to a survey posted on social media sites' closed groups that focused on post-natal issues. Design was cross-sectional, with CHB as the outcome variable (14 items) and demographics and feeding status as the explanatory variables. RESULTS: The internal reliability of the CHB scale was α = 0.87. There was a statistically significant difference in the level of CHB between non-breastfeeding women, breastfeeding women, and women who combined breastfeeding with infant formula, so that non- breastfeeding women had the highest level of CHB. There was no significant difference in CHB by either birth experience or demographic characteristics. CONCLUSION: This study extended CHB to breastfeeding, documenting the minimization of the disadvantages of not breastfeeding by non-breastfeeding women, attempting to neutralize or reduce the cognitive dissonance between non-nursing and optimal infant care. Possible uses of the scale for counselling were suggested, both in the prenatal and post-natal period, proactively bringing forward and addressing ambivalence towards breastfeeding.


Assuntos
Atitude Frente a Saúde , Aleitamento Materno , Mães , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Lactente , Cuidado do Lactente , Fórmulas Infantis , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Adulto Jovem
8.
PLoS One ; 15(8): e0237820, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32841257

RESUMO

Majority of neonatal deaths in developing countries have been associated with inappropriate or poorly practiced newborn care, specifically safe cord care, optimal thermal care and early initiation and practice of exclusive breastfeeding. There is limited information about the quality of these essential newborn care practices in Accra, Ghana. The main objective of this study was to assess the knowledge about and quality of essential newborn care practices (ENC) and determine related factors in La Dade Kotopon Municipal Assembly, Accra, Ghana. A questionnaire-based, cross-sectional study was conducted among 423 mothers and caregivers in two hospitals to assess safe cord care, optimal thermal care and exclusive breastfeeding. Knowledge was assessed using eight statements regarding ENC and categorized as 'Adequate knowledge' and 'Inadequate knowledge' using a composite score. Practices were similarly categorized as 'Good' and 'Poor' ENC. Data were exported from Microsoft Excel into STATA version 15 for statistical analysis. Descriptive statistics were generated and inferential analysis was done using chi-square test and logistic regression to determine factors associated with good ENC at 95% confidence level. All respondents sampled participated in the study. A total of 263 (62%) respondents had adequate knowledge and 308 (73%) respondents practiced appropriate newborn care ('Good' ENC). The likelihood of appropriate newborn care practices was lower among mothers/caregivers who were unemployed (AOR = 0.13, 95% CI: 0.09-0.26), who had a home delivery (AOR = 0.17, 95% CI: 0.11-0.69) and made their first antenatal visit in the third trimester (AOR = 0.02, 95% CI: 0.01-0.35) compared to their counterparts. Knowledge of ENC was not associated with practice in this study. Appropriate newborn care practices were relatively high among the respondents. Improving sources of livelihood and targeted education to encourage early antenatal visits and facility-based births might improve newborn care where it is inadequate.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Cuidado do Lactente/normas , Adulto , Cuidadores , Feminino , Gana , Humanos , Recém-Nascido , Modelos Logísticos , Serviços de Saúde Materna , Mães , Adulto Jovem
10.
Matern Child Health J ; 24(Suppl 2): 163-170, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32860586

RESUMO

PURPOSE: The New Mexico Graduation Reality and Dual-role Skills (GRADS) program provides services for expectant and parenting students at high schools. The GRADS program has operated since 1989, serving more than 17,000 youth. This study summarizes the GRADS program model and program administrators' lessons learned from implementing this comprehensive, large-scale program. DESCRIPTION: The GRADS program is a multicomponent intervention that can include a classroom intervention, case management, linkages to child care and health care, and support for young fathers. The program aims to support expectant and parenting youth in finishing high school, delaying a repeat pregnancy, promoting health outcomes for their children, and preparing for college and career. This study presents program administrators' lessons learned to increase understanding of how to implement a statewide program to support expectant and parenting students. ASSESSMENT: During the 2010-2017 school years, the GRADS program operated in 26-31 sites each year, serving a total of 2691 parenting youth. Program administrators identified lessons learned from implementing the GRADS program during that period of expansion, including allowing variation across sites based on resources and needs, providing centralized implementation support, fostering buy-in from school and district leaders, and collecting consistent data to better understand participant outcomes. CONCLUSIONS: Although not based on a rigorous impact or implementation study, this article provides lessons learned from a statewide, school-based program that may be a promising way to serve a large number of expectant and parenting youth and help them overcome challenges for completing high school.


Assuntos
Cuidado do Lactente , Poder Familiar , Pais/educação , Estudantes , Adolescente , Feminino , Humanos , Recém-Nascido , New Mexico , Gravidez , Gravidez na Adolescência , Instituições Acadêmicas , Adulto Jovem
11.
Curr Opin Pediatr ; 32(4): 610-618, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32618790

RESUMO

PURPOSE OF REVIEW: The present coronavirus disease 2019 (COVID-19) pandemic has created additional challenges with an increased number of presumed healthy, full-term newborns being discharged at 24 h after delivery. Short lengths of stay raise the possibility of mother-infant dyads being less ready for discharge, defined as at least one of the three informants (i.e., mother, pediatrician, and obstetrician) believing that either the mother and/or infant should stay longer than the proposed time of discharge. This public health crisis has reduced the number of in-person well child visits, negatively impacting vaccine receipt, and anticipatory guidance. RECENT FINDINGS: Extra precautions should be taken during the transition period between postpartum discharge and follow-up in the ambulatory setting to ensure the safety of all patients and practice team members. This should include restructuring office flow by visit type and location, limiting in-person visits during well infant exams, instituting proper procedures for personal protective equipment and for cleaning of the office, expanding telehealth capabilities for care and education, and prioritizing universal vaccinations and routine well child screenings. SUMMARY: Based on current limited evidence, this report provides guidance for the postdischarge management of newborns born to mothers with confirmed or suspected disease in the ambulatory setting as well as prioritizing universal immunizations and routine well child screenings during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Coronavirus , Cuidado do Lactente , Pandemias , Alta do Paciente , Pneumonia Viral , Betacoronavirus , Criança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Cuidado do Lactente/normas , Recém-Nascido , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Período Pós-Parto
12.
PLoS One ; 15(7): e0235593, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32634171

RESUMO

BACKGROUND: To decrease contamination of needleless catheter hubs, caps or port protectors impregnated with isopropanol (IPA) have been developed and shown to be superior to other disinfection methods. The safety of the caps has been questioned, as they can be associated with alcohol leakage across the hub membrane. OBJECTIVES: We evaluated the use of IPA caps and the scrub-the-hub method from the safety standpoint of possible alcohol leakage across the hub membrane. METHODS: Circuits imitating an intravenous line were constructed. Circuits with an IPA cap were flushed with sodium chloride after the hub had been exposed to the cap for 1 hour, 24 hours, and 7 days. At the end of each period the fluid was collected and amounts of IPA in it were measured, using gas chromatography. Scrub circuits without IPA caps were also tested and ethanol from these was measured using the same method. RESULTS: In this in vitro study, IPA was detected in all samples from cap circuits, and ethanol was detected from all scrub circuits. Leakage increased over time in IPA circuits. After 24 hours and 7 days of exposure, the first injection resulted in higher amounts of IPA; thereafter, the levels decreased. The amounts of ethanol measured from the scrub circuits were low. CONCLUSIONS: IPA caps can cause leakage of alcohol across the hub membrane. Leakage increased over time, and a 30 sec drying time was not sufficient to solve the problem. Scrub-the-hub seems safe to use with regard to alcohol leakage.


Assuntos
2-Propanol/análise , Desenho de Equipamento , Infecções Relacionadas a Cateter/prevenção & controle , Cromatografia Gasosa/métodos , Humanos , Cuidado do Lactente , Recém-Nascido
13.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47654

RESUMO

Diante das incertezas e falta de evidências científicas quanto à possibilidade de transmissão do novo coronavírus ao feto por mulheres grávidas diagnosticadas ou com suspeita de covid-19, médicos do Hospital das Clínicas (HC) da Faculdade de Medicina da USP (FMUSP), preparam protocolos de cuidados com os recém-nascidos durante e após o parto.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/prevenção & controle , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Cuidado do Lactente , Protocolos Clínicos , Tocologia
14.
Acta Paediatr ; 109(9): 1713-1716, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32544288

RESUMO

The global COVID-19 pandemic has been associated with high rates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, morbidity and mortality in the general population. Evidence-based guidance on caring for babies born to mothers with COVID-19 is needed. There is currently insufficient evidence to suggest vertical transmission between mothers and their newborn infants. However, transmission can happen after birth from mothers or other carers. Based on the currently available data, prolonged skin-to-skin contact and early and exclusive breastfeeding remain the best strategies to reduce the risks of morbidity and mortality for both the mother with COVID-19 and her baby.


Assuntos
Infecções por Coronavirus/prevenção & controle , Cuidado do Lactente , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Complicações Infecciosas na Gravidez/virologia , Infecções por Coronavirus/transmissão , Medicina Baseada em Evidências , Feminino , Humanos , Recém-Nascido , Pneumonia Viral/transmissão , Guias de Prática Clínica como Assunto , Gravidez
16.
PLoS One ; 15(6): e0234252, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32511258

RESUMO

Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make cross-setting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.


Assuntos
Cuidado do Lactente/métodos , Saúde Materna , Feminino , Humanos , Recém-Nascido , Medição de Risco
17.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(5): 498-502, 2020 May 06.
Artigo em Chinês | MEDLINE | ID: mdl-32388949

RESUMO

Newborn death accounts for half of under 5 child death in China. Decreasing neonatal mortality and improving health status of children at early stage of life have great significance on public health. This is also a solution to accomplish the goal of "ending preventable newborn deaths" of the 2030 Agenda for Sustainable Development. According to the World Health Organization, many causes leading to newborn deaths can be prevented and avoided by simple interventions. "Early Essential Newborn Care (EENC) " is a package of simple interventions that include early mother to child skin to skin contact, delayed umbilical cord clamping, breast feeding, kangaroo mother care for preterm, neonatal resuscitation, and infection identifying and treatment. These prioritized evidence-based interventions can improve the content and quality of newborn health care, which are bound to be promoted and implemented throughout the country. Future research should be conducted to explore solutions to solve difficulties and challenges of EENC implementation.


Assuntos
Cuidado do Lactente/métodos , Mortalidade Infantil , Método Canguru , China , Assistência à Saúde , Feminino , Humanos , Lactente , Recém-Nascido , Transmissão Vertical de Doença Infecciosa
18.
Sante Publique ; HS1(S1): 105-111, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32374089

RESUMO

INTRODUCTION: Driven by international programs specifically targeting neonatal survival, a set of recommended care practices is being promoted in West Africa. Using data from a multi-centered anthropological study, we enquire as to how local practices integrate the recommendations disseminated by these programs. METHOD: The surveys were conducted in rural localities in five countries: Benin, Burkina Faso, Mali, Mauritania, and Togo. In every site, the investigations combined ethnography of newborn care and in-depth interviews in maternity homes and homes. RESULTS: The care of newborns is based on a set of local social representations and logics, where medical recommendations are integrated heterogeneously. In maternity wards, health professionals face difficulties in implementing recommended practices, and make various conciliations when faced with local material and social constraints. In private homes, the "messages" promoting life-saving care for newborns punctuate conversations, but lead to various interpretations and variations in care. DISCUSSION: The irregular integration of medical recommendations in neonatal care is analyzed around three areas: the divergence of intentions around the birth, the dissonances between the recommended care and the local conceptions of the newborn, the influence of intra-family power relations. Considering the complexity of the changes in neonatal care, we argue for the implementation of programs that respect local cultures, and for health professionals to skillfully accommodate conflicting constraints.


Assuntos
Atitude do Pessoal de Saúde , Cuidado do Lactente/métodos , População Rural , Cordão Umbilical , África Ocidental , Antropologia Cultural , Benin , Feminino , Fidelidade a Diretrizes , Guias como Assunto , Humanos , Recém-Nascido , Gravidez , Inquéritos e Questionários
19.
Sante Publique ; HS1(S1): 17-27, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32374091

RESUMO

INTRODUCTION: Driven by international programs specifically targeting neonatal survival, a set of recommended care practices is being promoted in West Africa. Using data from a multi-centered anthropological study, we enquire as to how local practices integrate the recommendations disseminated by these programs. METHOD: The surveys were conducted in rural localities in five countries : Benin, Burkina Faso, Mali, Mauritania, and Togo. In every site, the investigations combined ethnography of newborn care and in-depth interviews in maternity homes and homes. RESULTS: The care of newborns is based on a set of local social representations and logics, where medical recommendations are integrated heterogeneously. In maternity wards, health professionals face difficulties in implementing recommended practices, and make various conciliations when faced with local material and social constraints. In private homes, the "messages" promoting life-saving care for newborns punctuate conversations, but lead to various interpretations and variations in care. DISCUSSION: The irregular integration of medical recommendations in neonatal care is analyzed around three areas: the divergence of intentions around the birth, the dissonances between the recommended care and the local conceptions of the newborn, the influence of intra-family power relations. Considering the complexity of the changes in neonatal care, we argue for the implementation of programs that respect local cultures, and for health professionals to skillfully accommodate conflicting constraints.


Assuntos
Cuidado do Lactente/métodos , África Ocidental , Antropologia , Feminino , Guias como Assunto , Pessoal de Saúde , Humanos , Recém-Nascido , Gravidez , Sobrevida
20.
Sante Publique ; HS1(S1): 29-43, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32374092

RESUMO

INTRODUCTION: In Sub-Saharan Africa, despite the establishment of many health care programs, neonatal mortality rates remain extremely high. From a medical point of view, the main causes are obstetric, along with diarrhea and pneumonia. Understanding how these risks and pathogenic situations are constructed cannot be achieved without observing, analyzing, and understanding the underlying gestures and meaning systems. METHOD: Rather than describing obvious inequalities in the access to health care, our study aimed at questioning the different actors' operational capacities and at considering what is actually possible to improve in the most common healthcare situations. More specifically, how are births, neonatal care, and popular practices carried out in the first days of the lives of these newborns? In five countries of West Africa, a "multi-sited" anthropological study was carried out to observe the first weeks of newborns. This study not only allowed for the methodical identification of care interactions at and around childbirth in peripheral health care services, but also the popular practices related to the socialization of the child in family settings. RESULTS: Our fieldwork investigations show that neonatal risk corresponds to the combination of several sets of behavior. In obstetric services, for reasons linked to the symbolic status of the child as much as to a certain idea of the obstetric profession, the newborn remains marginal in the preoccupations of the midwives. This results in many dysfunctions (not warming the child, leaving the child in a drafty area, not feeding the child…) which constitute discontinuous risk factors.In the village and in the family, the newborn is at the center of many social practices - baths, rituals, ingestions of various "protective" products, period of seclusion, baptism… - which not only aim at conferring an identity and including the infant in the social group, but also build a set of infectious risks.Finally, while health actions build a translation space, no preventive dialogue has been established by healthcare personnel to inform people about the risks associated with certain social practices.Overall, these longitudinal follow-ups of newborns, as well as precise observations and interviews conducted with the actors on their reasons for acting, have made it possible to analyze the attitudes, gestures and social behaviors that constitute the concrete causes of neonatal risk. DISCUSSION: Describing the practices that newborns "benefit from" during their first days is essential to concretely identify and analyze the risks and reasons for high neonatal mortality. The empirical and documented approach of anthropology is essential to carry out these studies. But, more importantly, this qualitative approach must be implemented in vivo and in situ in the health services and during the training of health personnel to create a reflexivity of the caregivers and to initiate professional practices concerned with newborns. In the same way, our studies open the way for precise and documented dialogues with families which will enable the indispensable follow-up care for the newborns and ensure adapted preventive care and coherence in the care provided by the healthcare structures, the families, and the collectivities.


Assuntos
Cuidado do Lactente/métodos , Mortalidade Infantil , Assistência Perinatal , África Ocidental , Antropologia , Criança , Parto Obstétrico , Feminino , Humanos , Lactente , Recém-Nascido , Serviços de Saúde Materna , Tocologia , Gravidez
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