Relevant bibliographies by topics / Newborn survival

Academic literature on the topic 'Newborn survival'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Newborn survival"

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Castle, Valerie, Geoffrey Coates, Lesley G. Mitchell, Hugh O’Brodovich, and Maureen Andrew. "The Effect of Hypoxia on Platelet Survival and Site of Sequestration in the Newborn Rabbit." Thrombosis and Haemostasis 59, no. 01 (1988): 045–48. http://dx.doi.org/10.1055/s-0038-1642563.

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SummaryThrombocytopenia occurs frequently in sick neonates that have experienced perinatal asphyxia. This study investigated the effect of one component of asphyxia, hypoxia, on platelet life-span and site of sequestration. 11 indium oxine platelet survivals with scintigraphic imaging were performed in newborn and adult rabbits exposed to room air (normoxia) or following exposure to a 15 minute, severe hypoxic insult (FjOa = 0.05). Platelet survivals in normoxic adults (n = 27) and newborn rabbits (n = 11) were similar (60 ± 3.9 hr vs 64 ± 8.0 hr, m ± SEM). Inhalation of 5% oxygen for 15 minutes was not associated with an acidemia and did not produce thrombocytopenia but significantly shortened the platelet survival to 34 ± 3 hr in the adult (n = 18) and 38 ± 3 hr in the newborn rabbit (n = 7). Postmortem measurement of the sites of mIn-platelet accumulation showed that under normoxic conditions the platelets accumulated in the liver and spleen (23 ±4.3% and 8 ± 1.0% of the total body counts) in the adult with even greater accumulation in the liver (58 ± 6.8%) and spleen (19 ± 4.9%) of the newborn (p <0.001). The latter observation was likely due to the relatively increased size of the liver and spleen in the newborn compared to the adult. Hypoxia did not alter the site of platelet sequestration in adults or newborns. Our results suggest that the newborn has the same platelet survival as the adult and that acute, severe hypoxia significantly shortens the survival of platelets in both groups. Although the sites of sequestration are qualitatively the same in the newborn, there is greater sequestration in the liver and spleen when compared to the adult.
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Darmstadt, Gary L., Jeremy Shiffman, and Joy E. Lawn. "Advancing the newborn and stillbirth global agenda: priorities for the next decade." Archives of Disease in Childhood 100, Suppl 1 (January 22, 2015): S13—S18. http://dx.doi.org/10.1136/archdischild-2013-305557.

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Remarkable advances have been made over the past decade in defining the burden of newborn mortality and morbidity and stillbirths, and in identifying interventions to address the major risk factors and causes of deaths. However, progress in saving newborn lives and preventing stillbirths in countries lags behind that for maternal mortality and for children aged 1–59 months. To accelerate progress, greater focus is needed on improving coverage, quality and equity of care at birth—particularly obstetric care during labour and childbirth, and care for small and sick newborns, which gives a triple return on investment, reducing maternal and newborn lives as well as stillbirths. Securing national-level political priority for newborn health and survival and stillbirths, and implementation of the Every Newborn Action Plan are critical to accomplishing the unfinished global agenda for newborns and stillbirths beyond 2015.
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Nadeem, Amraha, Hitesh Deshmukh, Jerilyn Gray, and Timothy Wang. "Intestinal commensal bacteria promote AT2 self-renewal and AT1 differentiation in an IL-22 dependent fashion and prepare the newborn to fight potentially fatal respiratory pathogens." Journal of Immunology 204, no. 1_Supplement (May 1, 2020): 225.30. http://dx.doi.org/10.4049/jimmunol.204.supp.225.30.

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Abstract We demonstrated that disruption of intestinal commensal bacteria with antibiotics (ABX) severely diminished the levels of cytokine interleukin (IL)-22 in the newborn lung and rendered the ABX-exposed newborn mice susceptible post challenge with Streptococcus pneumoniae (S. pneumoniae). These experimental data suggest that colonization by intestinal commensal bacteria is vital for newborn’s lung defense against respiratory pathogens. Pregnant mouse dams were treated with ABX, and newborn mice were challenged with intratracheal S. pneumoniae (on postnatal day 5). Lungs were harvested and stained. AT2 cells and fibroblast harvested from ABX-treated or ABX-free newborn mice were cultured in matrigel to generate alveolar organoids. After harvest, the organoids were stained. To test the role of IL-22 signaling, Il22rafl/fl mice were bred with SftpcCreERT2 mice. The progeny was treated with tamoxifen and then challenged with S. pneumoniae. We found increased alveolar injury, loss of AT1 cells and reduced the frequency of proliferating AT2 cells in ABX-treated newborn mice compared to ABX-free newborn mice post-challenge with S. pneumoniae. Reconstitution of intestinal commensal bacteria or treatment with recombinant IL-22 restored the numbers of proliferating AT2 cells, reduced the injury score, and improved survival in ABX-treated newborn mice. Organoids derived ABX-exposed newborns demonstrated reduced growth and diminished AT1 differentiation. Using a developmentally appropriate and clinically relevant model, we report that intestinal commensal bacteria promote AT2 self-renewal and AT1 differentiation in an IL-22 dependent fashion, thus preparing the newborn to fight potentially fatal respiratory pathogens.
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Qazi, Mahvish, Najmus Saqib, and Rohit Raina. "Knowledge regarding prevention of hypothermia in newborns among mothers in Northern India." International Journal of Research in Medical Sciences 7, no. 5 (April 26, 2019): 1727. http://dx.doi.org/10.18203/2320-6012.ijrms20191666.

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Background: Neonatal hypothermia is increasingly recognized as a risk factor for newborn survival. World Health Organization (WHO) recommends maintaining a warm chain and skin-to-skin care for thermo-protection of newborn children. Since little is known about practices related to newborn hypothermia, this study’s goal was to assess the knowledge of mothers of newborns especially LBW babies on prevention of hypothermia and to provide them the knowledge of cost-effective thermal protection measures.Methods: It was a cross-sectional study using pre-tested, pre-structured questionnaire. 108 postnatal mothers having LBW babies admitted in postnatal wards of Government Medical College, Jammu, Jammu and Kashmir, India were included in the study and analysed using SPSS version 20.Results: Out of 108 mothers, maximum mothers were of age less than 25 years (51%), 60% were from rural area, residing in nuclear family were 62%. Mothers attended hospital for confinement were 95% and 85% started breast feeding their babies. 45% had knowledge of keeping the baby warm by immediately wiping the baby and only 3% mothers had knowledge of Kangaroo Mother Care (KMC).Conclusions: Understanding and addressing community-based practices on hypothermia, prevention and management might help to improve newborn survival in resource-limited settings. Possible interventions include the implementation of skin-to-skin care in rural areas and the use of appropriate, low-cost newborn warmers to prevent hypothermia and support families in their provision of newborn thermal protection. Training family members to support mothers in the provision of thermo-protection for their newborns could facilitate these practices. Those who fail to fully attend antenatal clinics should be targeted for newborn care education.
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Niermeyer, S., A. Tobin, E. Schoen, T. Carter, and J. D. Klein. "A New Commitment to Newborn Survival." PEDIATRICS 135, no. 2 (January 5, 2015): 211–12. http://dx.doi.org/10.1542/peds.2014-3185.

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George, Caroline L. S., Kelli L. Goss, David K. Meyerholz, Fred S. Lamb, and Jeanne M. Snyder. "Surfactant-Associated Protein A Provides Critical Immunoprotection in Neonatal Mice." Infection and Immunity 76, no. 1 (October 29, 2007): 380–90. http://dx.doi.org/10.1128/iai.01043-07.

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ABSTRACT The collectins surfactant-associated protein A (SP-A) and SP-D are components of innate immunity that are present before birth. Both proteins bind pathogens and assist in clearing infection. The significance of SP-A and SP-D as components of the neonatal immune system has not been investigated. To determine the role of SP-A and SP-D in neonatal immunity, wild-type, SP-A null, and SP-D null mice were bred in a bacterium-laden environment (corn dust bedding) or in a semisterile environment (cellulose fiber bedding). When reared in the corn dust bedding, SP-A null pups had significant mortality (P < 0.001) compared to both wild-type and SP-D null pups exposed to the same environment. The mortality of the SP-A null pups was associated with significant gastrointestinal tract pathology but little lung pathology. Moribund SP-A null newborn mice exhibited Bacillus sp. and Enterococcus sp. peritonitis. When the mother or newborn produced SP-A, newborn survival was significantly improved (P < 0.05) compared to the results when there was a complete absence of SP-A in both the mother and the pup. Significant sources of SP-A likely to protect a newborn include the neonatal lung and gastrointestinal tract but not the lactating mammary tissue of the mother. Furthermore, exogenous SP-A delivered by mouth to newborn SP-A null pups with SP-A null mothers improved newborn survival in the corn dust environment. Therefore, a lack of SP-D did not affect newborn survival, while SP-A produced by either the mother or the pup or oral exogenous SP-A significantly reduced newborn mortality associated with environmentally induced infection in SP-A null newborns.
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Prabhu, Deepa Fernandes, and Richard C. Larson. "Scaling the Maternal and Newborn Survival Initiative (MANSI)." International Journal of System Dynamics Applications 8, no. 1 (January 2019): 94–111. http://dx.doi.org/10.4018/ijsda.2019010106.

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The infant mortality rate (IMR) and maternal mortality ratio (MMR) are unacceptably high in many parts of rural India. This article focuses on a system analysis approach to the best practices for scaling and replicating of maternal and newborn survival initiative (MANSI), a field-tested pilot program for addressing high IMRs and MMRs. A system dynamics model of the village birthing system is used to understand the resources needed for the viability of scaling or replication, is constructed and incorporated in the analysis. The MANSI program is a public and private partnership between a few key players. Implemented in the Seraikela area of India's Jharkhand state, the program has achieved a 32.7% reduction in neonatal mortality, a 26.5% reduction in IMR, and a 50% increase in hospital births, which tend to have better health outcomes for women and newborns. The authors conclude with a discussion of the prospects for and difficulties of replicating MANSI in other resource-constrained areas, not only in India but in other developing countries as well.
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Synnes, Anne R. "Use of the laboratory in prediction of outcome in the high-risk newborn." Clinical Chemistry 43, no. 1 (January 1, 1997): 243–48. http://dx.doi.org/10.1093/clinchem/43.1.243.

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Abstract This paper reviews our ability to predict survival and neurodevelopmental outcome in the newborn period. Traditionally, prognosis is based on individual risk factors or disease states. The laboratory plays an important role in diagnosing some of these. For example, prenatal and newborn screening are important in the diagnosis of chromosomal abnormalities and inborn errors of metabolism. Abnormal bilirubin, glucose, and pH values in the newborn period are risk factors for death and abnormal neurodevelopment, and the degree of abnormality imparts additional information. Many newborns have multisystem disorders, and it is only when multiple variables are considered that outcome can be predicted. Three neonatal scores that incorporate multiple variables are discussed. Methodologic difficulties in determining outcome are reviewed and illustrated with survival and morbidity rates of very premature babies. The laboratory is one of many prognostic variables. The evaluation of how laboratory services are provided is difficult but important.
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Richard Okonkwo, Ikechukwu, Blessing Imuetinyan Abhulimhen-Iyoha, and Angela Anene Okolo. "Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria." American Journal of Pediatrics 6, no. 3 (2020): 346. http://dx.doi.org/10.11648/j.ajp.20200603.39.

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Berkley, Seth, Mark Dybul, Tore Godal, and Anthony Lake. "Integration and innovation to advance newborn survival." Lancet 384, no. 9938 (July 2014): e22-e23. http://dx.doi.org/10.1016/s0140-6736(14)60691-7.

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Dissertations / Theses on the topic "Newborn survival"

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Cai, Weikang. "RIT GTPASE SIGNALING MEDIATES OXIDATIVE STRESS RESISTANCE AND SURVIVAL OF ADULT NEWBORN NEURONS AFTER TRAUMATIC BRAIN INJURY." UKnowledge, 2011. http://uknowledge.uky.edu/biochem_etds/1.

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The small GTPases function as molecular switches to control diverse signaling cascades. The mammalian Rit and Rin, along with Drosophila Ric, comprise an evolutionarily conserved subfamily of the Ras-related GTPases. Previous studies using cultured cell models suggested that Rit was involved in the control of cell proliferation, transformation, neuronal differentiation, morphogenesis, and cell survival, but the principal physiological function of Rit remained uncharacterized. To address this outstanding question, we employed a genetic approach, engineering a Rit knockout mouse. Using this animal model, we demonstrate a central role of Rit in governing cell survival in a p38-dependent fashion. Primary mouse embryonic fibroblasts (MEFs) derived from Rit-/- mice display increased apoptosis and selective disruption of MAPK signaling following oxidative stress. These deficits include a reduction in ROS-mediated stimulation of a novel p38-MK2-HSP27 signaling cascade, which appears to act upstream of the mTORC2 complex to control Akt-dependent cell survival. In the adult brain, proliferation of stem cells within the subgranular zone (SGZ) of the hippocampal dentate gyrus (DG), provide a lifelong supply of new neurons. Adult neurogenesis appears critical for learning and memory and is altered in animal models of brain injury and neurological diseases. Thus, a greater understanding of the regulation of adult neurogenesis will provide insight into its myriad physiological roles but also to the development of therapeutic strategies for the treatment of injury and the progression of brain diseases. Here we find that Rit plays a central role in governing the survival of hippocampal neurons in response to oxidative stress. Importantly, using a controlled cortical impact model of traumatic brain injury (TBI), we show that Rit acts to protect newborn immature neurons within the SGZ of the DG from apoptosis following TBI. Finally, studies indicate that Rit plays a significant role in directing IGF-1 signaling, a key neurotrophin known to promote neurogenesis and to protect neurons against apoptotic stress. Together, these studies establish Rit as a critical regulator of a p38 MAPKdependent signaling cascade that functions as an important survival mechanism for cells in response to oxidative stress, including the survival of newborn hippocampal neurons in the traumatically injured brain.
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Ijumba, Petrida. "Intervention for improved newborn feeding and survival where HIV is common : Perceptions and effects of a community-based package for maternal and newborn care in a South African township." Doctoral thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-232110.

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South Africa recently changed infant feeding policy within Prevention of Mother to Child Transmission (PMTCT) of HIV from free formula to recommendation of breastfeeding for all. The country is evaluating the role of Community Health Workers (CHWs) in supporting mothers and newborns. The aim of this thesis is to explore perceptions of household members on the value given to and the social forces behind formula feeding in light of the recent policy change, and to assess the effect of a community-based package of maternal and newborn care delivered by CHWs on HIV-free survival and exclusive and appropriate infant feeding up to 12 weeks of age. Studies were conducted in a high HIV prevalence township. Focus group discussions were performed (grandmothers, fathers and teenage mothers) and in-depth interviews with HIV-positive and HIV-negative mothers. Perceptions of household members on the formula policy change were explored and the value household members place on formula feeding and circumstances that drive it. In a cluster-randomized trial (15 intervention, 15 control clusters) CHWs provided two antenatal and five post-natal home visits to support and promote PMTCT activities. There were misunderstandings by community members on the free formula policy change. Mothers transferred the motherhood role to their mothers while partners provided inadequate financial support, leading to risky mixed feeding. Teenage mothers rarely breastfed their infants due to perceived constraints including embarrassment, sagging breasts and loss of freedom and boyfriends. At 12 weeks of age the intervention had doubled exclusive breastfeeding (EBF) (28% vs. 14%) and slightly increased infant weight and length. No difference was seen between study arms in HIV-free survival. The effect on EBF at12 weeks did not differ with maternal education or wealth levels, but was higher among HIV-negative mothers.  Focusing on teenage mothers breastfeeding challenges, involvement of grandmothers and fathers in infant feeding decision-making, improving communication strategies on policy change and breastfeeding to the community and health workers and CHWs home visits supporting PMTCT activities are important for infant feeding and child health.
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Nicol, Edward Fredrick. "Evaluating the process and output indicators for maternal, newborn and child survival in South Africa : a comparative study of PMTCT information systems in KwaZulu-Natal and the Western Cape." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/97073.

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Thesis (PhD)--Stellenbosch University, 2015.
ENGLISH ABSTRACT: The prevention of mother-to-child transmission (PMTCT) of HIV is a key maternal and child health intervention in the context of the HIV/AIDS pandemic in South Africa. Accordingly, the PMTCT programme has been incorporated in the District Health Management Information System (DHMIS) that collects monthly facility-based data to support the management of public health services. To date, there has not been a comprehensive evaluation of the PMTCT information system. By comparing the experiences in two health districts, using the Performance of Routine Information System Management (PRISM) framework and tools, this study seeks to evaluate the availability, quality and use of process and output indicators for monitoring PMTCT interventions. A comparative analytical and observational study was undertaken using a multi-method approach which included: a self-administered survey of health information personnel to assess confidence and competence levels for routine health information system (RHIS) tasks, an assessment of the routine PMTCT data for quality, completeness, accuracy, and data use; and a facility survey of RHIS processes and resources. In addition, in-depth interviews with 22 key informants and observations in health facilities were conducted. Data were collected from 57 health facilities in a convenience sample of two health districts, and also from 182 health information personnel in the 57 health facilities, three sub-districts, and two district offices. Descriptive statistics, χ2-test, correlation and multiple regression analyses were conducted using STATA® Version 13. A general inductive approach was also used to analyse the qualitative data, which was used for triangulation. The study revealed considerable data quality concerns for the PMTCT information with an average accuracy between the register and routine monthly report of 51% and between the routine monthly reports and DHMIS database of 84% suggesting that the primary point of departure for accurate transfer of data is during the collation process. The importance of human factors was emphasised by the observation that the average confidence level for performing RHIS-related tasks (69%) was not commensurate with the average competence levels (30%). Education was found to be associated with competence, implying that levels of education may be associated with the level at which RHIS competencies are acquired; and that three years or more of post-matriculation education is necessary. Motivation, on the other hand was not associated Stellenbosch University https://scholar.sun.ac.za iv with competence. The study observed the absence of processes such as data-quality checks and data-analysis in place in facilities. There was a general absence of a culture of information use, as a result of lack of trust in the data, and the inability of programme and facility managers to analyse, interpret and use information. We observed differences in the data accuracy by organisational authority, and multivariate analysis and qualitative information suggested that feedback may be an essential process to ensure quality. Although the PRISM framework has been developed from a multi-disciplinary evidence base, this study has been able to validate some of the internal assumptions but has also found some aspects that were not supported such as motivation and data display. Data collected from a larger number of facilities will be required to investigate this further. Institutional capacity to improve RHIS processes, ensure core competencies for RHIS-related tasks are needed, and in the longer term, measures to tackle problems associated with low pass rates in numeracy subjects among high school learners are needed. Further exploration of the possible factors that may influence data accuracy, such as supervision, training and leadership are needed as well as investigating the relationships between human and institutional agency-related aspects, in particular, how individual actions can bring about changes in institutional routines. Further study is needed to determine how decision for planning and evaluating key programmes such as PMTCT are made, and what informs such decisions if not routine data.
AFRIKAANSE OPSOMMING: In die lig van Suid Afrika se MIV/VIGS-pandemie kan ’n ingryping op gesondheidsvlak ’n belangrike rol speel om moeder-na-kind-oordrag (beter bekend as PMTCT) van MIV te voorkom. ’n Inligtingstelsel vir distriksgesondheidsbestuur – die DHMIS – was ontwerp vir die invordering van maandelikse fasiliteitsdata, wat gebruik kan word om die bestuur van openbare gesondheidsdienste en -programme te ondersteun. Die inligtingstelsel self was nog nie omvattend evalueer nie. Hierdie studie het die ervarings van twee gesondheidsdistrikte vergelyk met behulp van die PRISM- (Performance of Routine Information System) raamwerk en -instrumente. Derhalwe het hierdie studie die beskikbaarheid, gehalte en gebruik van proses- en uitsetaanwysers probeer bepaal om die PMTCT-ingrypings te monitor. ’n Vergelykende analitiese en waarnemingstudie is onderneem met behulp van ’n veelvuldige benadering. Die verskillende metodes het ’n selfopname onder gesondheidsinligtingspersoneel ingesluit om hul selfvertroue en bevoegdheid in roetinegesondheidsinligtingstelsel (RHIS)-take te evalueer. Daar was ook ’n assessering van die PMTCT-roetinedata om datagehalte, -volledigheid, -akkuraatheid en -gebruik te beoordeel.’n Fasiliteitsopname oor RHIS-prosesse en –hulpbronne was ook gedoen. Ander navorsingsmetodes het diepte-onderhoude met 22 sleutelpersone ingesluit, sowel as waarnemings in gesondheidsfasiliteite. Data is van 182 gesondheidsinligtingpersoneel van die 57 gesondheidsfasiliteite in ’n geriefsteekproef van twee gesondheidsdistrikte ingesamel. Deskriptiewe statistiek, χ2-toetsing, korrelasie en veelvoudige regressie is met behulp van STATA® weergawe 13 ontleed. ʼn Algemene induktiewe benadering is ook gevolg om die kwalitatiewe data te ontleed. Die studie toon dat menslike faktore ’n impak op datagehalte en -inligting kan hê, met ’n gemiddelde akkuraatheidsyfer van 51% van beide die register en roetine maandelikse verslae. Die akkuraatheid van die maandelikse verslae en RHIS databasis is 84%, wat aandui dat akkuraatheid slegs toegepas word indien inligting uit die staanspoor korrek aangeteken word. Die impak van menslike hulpbronafaktore was beklemtoon toe daar bevind was dat hoewel 69% van RHIS-dataverwerkers vertroue getoon het in die gebruik van RHIS-verwante take, slegs 30% wel bevoeg was om die werk te doen. Opvoeding was grootliks geassosieer met bevoegdheid, wat moontlik voorstel dat sekere vlakke van opvoeding benodig word vir spesifieke RHIS-bevoegdhede. Minsten drie jaar tersiêre opleiding word aanbebeel. Motivering was nie met Stellenbosch University https://scholar.sun.ac.za vi bevoegdheid geklassifeer nie. Die studie het bevind dat daar te min aandag aan datagehalte en –analise gegee word in fasiliteite. Oor die algemeen was daar nie ’n ordentlike kultuur van inligtinggebruik nie, a.g.v. die feit dat daar nie vertroue in die data was nie. Terselftertyd was program- en fasiliteitbestuurders nie bevoeg om inligting te analiseer en ontleed nie. Ons het verskille in die akkuraatheid van data opgetel wat deur organisasie-hoofde gedoen was. Meervoudige analise en kwalitatiewe informasie stel voor dat terugvoering ’n belangrike deel van die proses moet wees om kwaliteit te verseker. Hoewel die PRISM-raamwerk saamgestel was uit ’n multi-dissiplinêre bewyslewering, kon hierdie studie sommige van die interne voorneme valideer, maar daar was aspekte wat nie gestaaf kon word nie. Inligting van ’n groter aantal fasiliteite sal benodig word om verder hierna ondersoek in te stel. Institusionele kapasiteit word benodig om RHIS-prosesses te verbeter en basiese vaardighede vir RHIS-verwante take te verseker. Op langtermynvlak moet daar ook gekyk word na probleme wat lei tot laë slaagsyfers in syfervaardighede in hoërskoolleerders. Verdere ondersoek moet ingestel word om vas te stel watter faktore moontlik akkurate data teweeg kan bring. Dit sluit toesig, opleiding en leierskap, asook die verhoudings tussen menslike en agentskap-verwante aspekte in. Die feit dat optrede op individuele vlak veranderings in institusionele roetines kan aanbring, moet spesifiek na gekyk word. Verdere studies kan help om vas te stel hoe besluite vir beplanning en evaluaring vir hoofprogramme soos PMTCT gemaak word – asook hoe die besluite gemaak word indien hulle nie roetine voorafgaan nie.
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Mbaruku, Godfrey. "Enhancing survival of mothers and their newborns in Tanzania /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-355-8/.

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Henriksson, Dorcus Kiwanuka. "Health systems bottlenecks and evidence-based district health planning : Experiences from the district health system in Uganda." Doctoral thesis, Uppsala universitet, Internationell mödra- och barnhälsovård (IMCH), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-329082.

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In low-income countries where maternal and child mortality remains high, there is limited use of context-specific evidence for decision making and prioritization of interventions in the planning process at the sub-national level, such as the district level. Knowledge on the utility of tools and interventions to promote use of district-specific evidence in the planning process is limited, yet it could contribute to the prioritization of high-impact interventions for women and children. This thesis aims to investigate, in the planning process, the use of district-specific evidence to identify gaps in service delivery in the district health system in Uganda in order to contribute to improving health services for women and children. Study I evaluated the use of the modified Tanahashi model to identify bottlenecks for service delivery of maternal and newborn interventions. Study II and III used qualitative methods to document the experiences of district managers in adopting tools to facilitate the utilization of district-specific evidence, and the barriers and enablers to the use of these tools in the planning process. Study IV used qualitative methods, and analysis of district annual health work plans and reports. District managers were able to adopt tools for the utilization of district-specific evidence in the planning process. Governance and leadership were a major influence on the use of district-specific evidence. Limited decision space and fiscal space, and limited financial resources, and inadequate routine health information systems were also barriers to the utilization of district-specific evidence. Use of district-specific evidence in the planning process is not an end in itself but part of a process to improve the prioritization of interventions for women and children. In order to prioritize high impact interventions at the district level, a multifaceted approach needs to be taken that not only focuses on use of evidence, but also focuses on broader health system aspects like governance and leadership, the decision and fiscal space available to the district managers, limited resources, and inadequate routine health information systems.
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Barua, Shampa. "Determinants of maternal and newborn health and survival in three rural areas of Bangladesh." Phd thesis, 2012. http://hdl.handle.net/1885/11802.

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Bangladesh has achieved impressive reductions in maternal deaths during the past two decades, but has not shown much progress in the use of skilled providers at childbirth or in postnatal care from trained providers. Both the Government and NGOs were implementing various interventions aimed at improving the health of mothers and newborns in the study area for this thesis. An in-depth knowledge of existing maternal and newborn care practices, and of related beliefs, is essential to assessing the success of such maternal and newborn care interventions, and to understanding the challenge improving the situation presents. Fieldwork was carried out in three unions of Ramu upazila in rural Bangladesh -Khuniapalong, Joarianala and Fatehkharkul. A total of 1,326 interviews were conducted, with data weighted to reflect the 1,783 women who were eligible to be interviewed. In addition, 40 in-depth interviews were conducted with different stakeholders. Women in Khuniapalong were appreciably poorer and less educated than those in Joarianala, who in turn were poorer and less educated than those in Fatehkharkul. Although most women had sought antenatal care (ANC), little more than a quarter of deliveries had been attended by skilled personnel. Women with higher secondary or higher education, in wealth quintiles 3-5, resident in Fatehkharkul, having a first birth, and having received a voucher/card for ANC and other services were especially likely to have received ANC three or more times from a trained provider. Over three-quarters of births had occurred at home, including almost all ofthose in Khuniapalong. Delivery complications, having received a voucher/card for free ANC, delivery and PNC services, residence in Fatehkharkul, belonging to wealth quintile 4 or 5, the birth being a first birth, having higher secondary or higher education (woman and her husband), and having had three or more ANC consultations were all predictive of hospital delivery. Skilled assistance at home births was related to having a first birth, experiencing complications, having had four or more ANC visits, belonging to the highest wealth quintile, and residence in Fatehkharkul. More than 70 percent of women had consulted somebody for postnatal care (PNC), but almost all PNC providers in Khuniapalong and two-thirds of those in Joarianala were unskilled, along with 40 percent of those in Fatehkharkul. Use of a skilled birth attendant was associated with having skilled PNC for both mothers and newborns, and with essential newborn care practices like clean cord care, immediate drying and wrapping, delayed bathing and early initiation of breastfeeding. These practices are still frequently not followed, being intertwined with cultural beliefs. Qualitative data showed that not consulting trained ANC and PNC providers and not using skilled birth attendants were associated with perceiving them to be ' not needed' . Skilled attendance at delivery and postpartum care for mother and newborn are crucial to improving the mother and newborn health situation in rural Bangladesh. Equitable coverage by health interventions along with community empowerment are keys to overcoming harmful cultural beliefs and norms around childbirth and thereby improving maternal and newborn health.
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Mashego, M. P. A. "Survival of very low birth and extreme low birth weight infants at Mankweng Neonatal Care Unit." Thesis, 2019. http://hdl.handle.net/10386/2930.

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Thesis (M.Med. (Paediatrics and Child Health)) -- University of Limpopo, 2019
Objectives To determine the prevalence and survival rate; and to assess the maternal risk factors as well as complications of prematurity, associated with the mortality of very low and extremely low birth weight infants in the Neonatal Intensive Care Unit (NICU) of Mankweng Hospital. Materials and Methods A retrospective descriptive study was conducted at the NICU of Mankweng Hospital for a 7-month period from 1st January to 31st July 2015. The patient medical records and the Perinatal Problem Identification Programme (PPIP) data were used for the study. Results Prevalence of prematurity was 23%, Infants weighing between 500g-1499g represented 6.3% of the total live births and 25% of the admissions to the NICU; of which 4.9% were classified as extremely low birth weight (ELBW). Overall 77% of the study population survived until discharge. From the medical records, the survival to discharge of infants with weight 500g - 999g was 52%; and 84% for those with weight 1000g-1499g. Multivariable analysis found that improved survival was associated with an increase in gestational age (p <0.001), as well as birth weight (p <0.001) and prolonged length of stay. Variables associated with poor survival were spontaneous preterm labour (p = 0.031), low Apgar score at 1 and 5 minutes (p <0.001), sepsis (p = 0.001), respiratory distress syndrome (p <0.001), pulmonary hemorrhage (p <0.001), hypothermia (P = 0.005), resuscitation at birth (p = 0.002) and necrotising enterocolitis (p =0.044). Antenatal steroids were not associated with survival (p =0.111), however this was not documented in 53%(134/252) of the records, so the non-significance to outcome in this study may not be a true reflection. The use of NCPAP or SiPAP only was associated with improved survival of up to 69% and high mortality rates were recorded in babies who required invasive ventilator support. Multi-organ immaturity was found to be the most common cause of death, followed by sepsis. Conclusion: The prevalence and survival rates of very low and extremely low birth weight, found in this study are comparable to those found in other tertiary hospitals in South Africa. The survival rate of ELBW babies is low and must be improved. Reliable data and further research should address effective steps to prevent preterm labour, extreme prematurity and hypothermia. The documentation and provision of antenatal steroids is encouraged. KEY CONCEPTS: Prematurity, Extremely low and Very low birth weight, Risk factors, Prevalence, Survival, Neonatal mortality rate.
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Savvas, Eleftherios George [Verfasser]. "Effects of prenatal glucocorticoids and postnatal nitric oxide inhalation on the survival and lung maturation of newborn rats with congenital diaphragmatic hernia / submitted by Eleftherios George Savvas." 2008. http://d-nb.info/990166015/34.

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"Searching for longevity determinants : following survival of newborns in a in-land village in Sardinia (1866-2006)." Université catholique de Louvain, 2009. http://edoc.bib.ucl.ac.be:81/ETD-db/collection/available/BelnUcetd-02052009-164722/.

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Mufeti, Johanna Penelao. "Factors associated with survival of newborns at hospital discharge at Charlotte Maxeke Johannesburg academic hospital, Johannesburg, South Africa from 01 January 2013 to 30 June 2014." Thesis, 2016. http://hdl.handle.net/10539/22453.

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Books on the topic "Newborn survival"

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Mahapatro, Sandhya R. Towards Newborn Survival. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9.

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The best 102 tips for first-time moms: The survival guide for the first year. Valencia, Calif: St. Clair René Pub., 1996.

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Long, Suzanne E. One year survival outcome of newborns by age of mother: South Carolina resident births, 1987 live birth/infant death cohort. Columbia, S.C: Division of Biostatistics, Office of Vital Records and Public Health Statistics, South Carolina Dept. of Health and Environmental Control, 1991.

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Khanal, Vishnu. A synthesis of recent studies on maternal and newborn survival interventions in Nepal. Kathmandu: Child Division, and Family Health Division, Department of Health Services, Ministry of Health and Population, 2014.

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Galway, Katrina. Child survival: Risks and the road to health. Columbia, MD: Institute for Resource Development at Westinghouse, 1987.

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Kompare, Tara. The colic chronicles: A mother's survival guide to calming your baby while keeping your cool. Boston, MA: Da Capo Press Lifelong Books, 2008.

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World Health Organization. Regional Office for South-East Asia. Prevention and control of birth defects in South-East Asia region: Strategic framework (2013-2017) : prevent birth defects-improve newborn survival-ensure quality of life and dignity. New Delhi, India]: World Health Organization Regional Office for South-East Asia, 2013.

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Williams, Glenn. Your marriage can survive a newborn. Nashville, Tenn: Broadman & Holman Publishers, 2005.

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Appelt, Kathi. The underneath. New York: Atheneum Books for Young Readers, 2008.

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Paulsen, Gary. Hatchet. New York: Bradbury Press, 1987.

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Book chapters on the topic "Newborn survival"

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Mahapatro, Sandhya R. "Access Barriers to Antenatal Care and Facility Delivery." In Towards Newborn Survival, 51–73. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_4.

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Mahapatro, Sandhya R. "Newborn Health: An Introduction." In Towards Newborn Survival, 1–19. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_1.

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Mahapatro, Sandhya R. "Neonatal Mortality in Bihar: Critical Reflections." In Towards Newborn Survival, 35–50. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_3.

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Mahapatro, Sandhya R. "Determinants of Newborn Survival in India." In Towards Newborn Survival, 21–34. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_2.

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Mahapatro, Sandhya R. "Direct Benefit Transfer and Newborn Health." In Towards Newborn Survival, 121–39. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_8.

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Mahapatro, Sandhya R. "Newborn Care Practices and Barriers to Service Utilisation." In Towards Newborn Survival, 87–103. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_6.

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Mahapatro, Sandhya R. "Conclusion and Way Forward." In Towards Newborn Survival, 141–54. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_9.

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Mahapatro, Sandhya R. "Access to Sick Newborn Care Services: Efficiency, Adequacy, and Equity." In Towards Newborn Survival, 105–19. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_7.

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Mahapatro, Sandhya R. "Quality of Care at Public Health Institutions: Identifying Gaps." In Towards Newborn Survival, 75–86. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-3417-9_5.

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Aquilina, Kristian, and Marianne Thoresen. "A Newborn Piglet Survival Model of Post-hemorrhagic Ventricular Dilatation (PHVD)." In Animal Models of Neurodevelopmental Disorders, 143–57. New York, NY: Springer New York, 2015. http://dx.doi.org/10.1007/978-1-4939-2709-8_10.

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Conference papers on the topic "Newborn survival"

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Patel, Megha, Emily Dugo, Nicole Tchiakpe, Lehila Tossa-Bagnan, Noe Akonde, Maroufou J. Alao, Genetics, Marcelline D'Almeida, and Nicole G. Rouvinez Bouali. "Breaking Barriers and Improving Newborn Survival through Kangaroo Mother Care in Benin, Sub-Saharan Africa." In AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.231.

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Mirsaidova, Manzura, Sherali Rahmatulloev, and Mutrib Bahruddinov. "Tajikistan: Helping Babies Breathe (HBB) and Essential Care for Every Baby (ECEB) Improve Newborn Survival." In AAP National Conference & Exhibition Meeting Abstracts. American Academy of Pediatrics, 2021. http://dx.doi.org/10.1542/peds.147.3_meetingabstract.253.

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Crehan, C., E. Kesler, B. Nambiar, Q. Dube, N. Lufesi, M. Giaconne, C. Normand, and M. Heys. "G286(P) The acceptability, feasibility and usability of the neotree application in malawi: an integrated data collection, clinical management and education mhealth solution to improve quality of newborn care and thus newborn survival in health facilities in resource-poor settings." In Royal College of Paediatrics and Child Health, Abstracts of the Annual Conference, 13–15 March 2018, SEC, Glasgow, Children First – Ethics, Morality and Advocacy in Childhood, The Journal of the Royal College of Paediatrics and Child Health. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/archdischild-2018-rcpch.278.

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Heys, M., C. Crehan, E. Kesler, B. Nambiar, Q. Dube, N. Lufesi, M. Giaccone, C. Normand, and K. Azad. "054 The acceptability, feasibility and usability of the neotree application in malawi: an integrated m-health solution to improve quality of newborn care and survival in health facilities in resource-poor settings." In Great Ormond Street Hospital Conference 2018: Continuous Care. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2018. http://dx.doi.org/10.1136/goshabs.54.

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Сандуляк, Т. В. "ПОПЕРЕДЖУВАНІСТЬ ЗАХВОРЮВАНЬ І ВІДВОРОТНІСТЬ ПРИЧИН СМЕРТІ ПЕРЕДЧАСНО НАРОДЖЕНИХ ДІТЕЙ З ВНУТРІШНЬОУТРОБНОЮ ІНФЕКЦІЄЮ." In International Trends in Science and Technology. RS Global Sp. z O.O., 2020. http://dx.doi.org/10.31435/rsglobal_conf/30122020/7349.

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We carried out research about disease prevention and avoiding of death causes in premature babies with different body masses and intrauterine infections at the modern perinatal center. Under conditions of help localization to pregnant women and newborns and implementation of acknowledged standards of the evidence-based medicine and perinatal strategies of health care to mother and child, we found out some demographic changes in the structure of birth giving, diseases and death of premature babies. Although there is a significant improvement of medical care quality to pregnant women and newborns, as well as an increase in the survival rate among premature newborns with very little and extremely little body masses, a number of newborns has grown who suffered from long-lasting infections and hypoxi before birth, which caused negative disease side-effects
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Silva, Matheus Henrique de Freitas, Karina Santos Wandeck, Sílvia Santiago Cordeiro, Ruth Lira Oliveira, and Síura Aparecida Borges Silva. "Experience of hypothermia as a therapeutic alternative for severe hypoxic-ischemic encephalopathy in a neonatal intensive care unit in Belo Horizonte." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.354.

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Introduction: Therapeutic hypothermia (TH) is an effective treatment alternative in newborns (NB) with moderate to severe hypoxic-ischemic encephalopathy (HIE). It is suggested that hypothermia, initiated in the first 6 hours after the hypoxic insult, by reducing brain metabolism, decreases cytotoxic edema, free radical production, neuronal excitability, the synthesis and release of neurotransmitters, nitric oxide and cytokines and apoptosis, mechanisms responsible for the late neurological lesions of EHI. Thus, TH improves survival and neurological prognosis in these newborns. Materials: Review of medical records of newborns submitted to TH in the period from 01/01/15 to 12/31/2015. Discussion: The TH protocol was implemented in the Unit from 01/01/2015, for all newborns older than 35 weeks, with evidence of moderate to severe HIE. TH starts in the first 6 hours of life and is performed for a period of 72 hours, after which rewarming begins, in the next 24 hours. In 2015, five newborns were submitted to the protocol. One of them died, on the fifth day of life, due to refractory shock and multiple organ failure. The other four newborns would be followed up on an outpatient basis. There was no need to stop hypothermia before 72 hours due to adverse events. The main events observed were bradycardia and shock, responsive to amines. Conclusion: The experience with TH showed good results in the medium term in newborns with moderate to severe HIE. The adverse events observed during the procedure were manageable, which suggests that TH can be an effective and safe alternative.
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Ellwanger, Juber Mateus, Caio Bertolini, Samuel Cavalcante Reis, Daniela Takito, and Priscila Ribas. "RECURRENT INFILTRATING DUCTAL CARCINOMA IN LEFT MASTECTOMY PLASTRON DURING PREGNANCY: A CASE REPORT." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1080.

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Introduction: Breast cancer has the highest incidence, prevalence, and mortality rate among malignant neoplasms in women worldwide (excluding non-melanoma skin cancer). Although there are well-defined treatments, they are still controversial during pregnancy: surgery seems safe and chemotherapy (CT) poses no harm to the fetus, especially if applied late in pregnancy. Hormone therapy (HT) and radiation therapy (RT) are prone to cause fetal damage. In patients diagnosed with pregnancy during treatment, there are no clear procedures about terminating the pregnancy or ceasing CT and RT. In these cases, it is necessary to monitor the patient and the fetus taking into account the woman’s will - especially if the tumor has estrogen and progesterone receptors, increasing the chance of relapsing or stop responding to CT. This study reports a case in which the hormones of pregnancy influenced a major recurrence of breast cancer, which diminished shortly after the birth. Case report: A 35-year-old woman, diagnosed with infiltrating ductal carcinoma in the left breast, underwent sectorectomy, axillary lymph nodes excision, and RT with an insufficient response. Subsequently, left tumor recurrence arose and mastectomy was performed. In the follow-up, she underwent CT and RT, with poor response. In the interim, it was discovered that the patient was pregnant, thus referred from oncology to gynecology for the interruption, since there was a considerable recurrence in the left breast plastron. Sixth -times pregnant, with five vaginal deliveries, the latest one six years before, all pregancies without complications. She was advised to terminate pregnancy but remained adamant in maintaining the pregnancy. She underwent an obstetric ultrasound showing a viable fetus of six weeks and six days of gestational age (GA). At 22 weeks of pregnancy, she was referred to the hospital by the oncologist for the interruption, as the plastron on the left breast was growing, with CT failure. The patient acknowledged that, with this GA, the fetus’s chance of survival was low. Yet, she opted for pregnancy continuation. Later she was sent by the prenatal care to the maternity hospital at 32 weeks of GA, aiming at delivery and a new CT protocol afterwards. She started corticosteroids for pulmonary development of the conceptus and endured cesarean delivery with bilateral adnexectomy. Female newborn, 1.830g, 8/9 APGAR score and 32 weeks and 5 days Capurro, transferred to the neonatal ICU (intensive care unit) due to prematurity. The patient was evaluated few months after delivery: great spontaneous resolution of the plastron in the left breast, with no effect of pregnancy hormones and responsive to CT. Follow-up in the oncology department.
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Naser, Nabil, and Zumreta Kušljugić. "ADULT CONGENITAL HEART DISEASE – NEW GUIDELINES AND CLINICAL CARE PERSPECTIVE." In International Scientific Symposium “Diagnostics in Cardiology and Grown-Up Congenital Heart Disease (GUCH)”. Academy of Sciences and Arts of Bosnia and Herzegovina, 2021. http://dx.doi.org/10.5644/pi2021.199.04.

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To date, the prevalence of CHD worldwide is ∼9 per 1000 newborns, with substantial geographic variation. The latest knowledge in the world for the last 50 years about their origin, diagnosis and therapy has contributed to their care. Since adult patients with CHD now present increasing numbers at advanced ages, including the elderly, the term grown-up CHD no longer appears appropriate and was therefore replaced with adult CHD (ACHD) according to the ESC guidelines published in 2020 year. Due to medical, surgical, and technological evolutions over the past decades, >90% of individuals who are born with CHD now survive into adulthood. ACHD represent a challenge for clinicians. Despite optimal medical and surgical treatment, many will experience a progressive decline in cardiopulmonary function leading to advanced heart failure. Severe ventricular dysfunction and/or pulmonary hypertension may not be amenable to corrective repair. Their early recognition and follow-up in adolescence will contribute to better care for these patients. Importantly, the care for ACHD patients is a lifelong process and requires advance care planning strategies.
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Reports on the topic "Newborn survival"

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Kangaroo mother care may boost the survival of newborn, premature babies. National Institute for Health Research, February 2016. http://dx.doi.org/10.3310/signal-000202.

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EUROPEAN STANDARDS OF CARE FOR NEWBORN HEALTH. Chernivtsi, Ukraine: Higher State Educational Establishment of Ukraine Bukovinian State Medical University, 2019. http://dx.doi.org/10.24061/2413-4260.ix.3.33.2019.1.

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Medical treatment and care for preterm and sick newborn babies in European countries varies greatly. Significant differences are not only limited to the survival rates of such infants. In some European countries, preterm birth is also more commonly associated with chronic physical and mental disability than in others. This effect is exacerbated by the fact that in some parts of Europe, further assistance to these vulnerable children after discharge from the hospital (follow-up and early intervention) is not structured or even does not exist at all. Given the high level of inequality in health care delivery, agreed definitions and clear recommendations for infrastructure, medical processes, care procedures, and staffing capabilities are needed to compare and adjust the conditions of care in Europe. Therefore, there is an absolute need to ensure that high-level care is equally available throughout and for everyone. European standards of care for newborn health, developed on the initiative and under the project of the European Foundation for the Care of Newborn Infants (EFCNI), will help to overcome differences in clinical practice, structure and organization of care, as well as training of healthcare professionals. This publication presents the part of the standards regarding health care for preterm and sick infants.
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Repositioning post partum care in Kenya. Population Council, 2005. http://dx.doi.org/10.31899/rh16.1013.

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In Kenya, although 45 percent of maternal deaths occur within the first 24 hours after childbirth and 65 percent of maternal deaths occur during the first week postpartum, health-care providers continue to advise on a first check-up six weeks after childbirth. The early postpartum period is also critical to newborn survival, with 50–70 percent of life-threatening newborn illnesses occurring in the first week. Yet most strategies to reduce maternal and perinatal morbidity and mortality have focused on pregnancy and birth. In addition to the heavy workload of providers who do not assess the mother post-delivery when she may bring her infant for immunization, lack of knowledge, poverty, cultural beliefs and practices perpetuate the problem. The only register that exists for mothers post-delivery is for family planning, thus perpetuating the lack of emphasis on the early postpartum period with no standardized register to record care given. To address this gap in service delivery, the Population Council defined the minimal services a mother and baby should receive from a skilled attendant after birth. As stated in this brief, the development of a standardized postpartum register is one step toward advocating for providing early postpartum care among health-service providers.
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Towards safe womanhood: Supporting safe motherhood initiatives and women's participation in development. Population Council, 1998. http://dx.doi.org/10.31899/rh1998.1047.

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Improvement in a woman’s quality of life is a prerequisite for development of human resources, because the quality of children’s physical and mental development is inextricably tied to the health and welfare of women as future mothers. If a mother is well protected during the pregnancy, birth, and postpartum period, the risk of illness and other problems in fetuses and newborn babies will be reduced. On the other hand, if a woman does not survive the pregnancy, birth, and postpartum period, her fetus or newborn will also be threatened. This paper provides a situation analysis of pregnant women, women in labor, and postpartum mothers, presenting also the level of morbidity and mortality of fetuses in the perinatal period (pregnancy from 28 weeks until the newborn is 7 days old), and, in more depth, the level of morbidity or mortality of infants in the neonatal period (age 0–28 days). Also presented are the risks and needs of reproductive-age couples or women of reproductive age (15–49 years), which require intervention at the individual, family, community, environmental, and national levels.
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Iron supplementation: Knowledge, perceptions, and usage among pregnant women in rural India. Population Council, 1997. http://dx.doi.org/10.31899/rh1997.1021.

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In India, severe anemia has been one of the causes of high maternal mortality and death of newborns and infants due to low birthweight. The prevalence of anemia among women ages 15–44 is extremely high. The Government of India has provided iron and folic acid tablets (IFA) as a prophylaxis against nutritional anemia among pregnant women as part of the Child Survival and Safe Motherhood program and will continue to do so in the Reproductive and Child Health package. This paper presents findings of both qualitative and quantitative research conducted among pregnant women to investigate the extent of distribution and use, information provision, and knowledge and perceptions regarding IFA tablets and reasons for nonuse. The study shows that consumption rate of IFA tablets is high if women are knowledgeable and have positive experiences after taking the tablets. Findings suggest that more accurate and complete information should be provided to pregnant women while distributing IFA tablets along with health and nutritional education messages. At the same time, follow-up visits and counseling are essential to address symptoms that are not related to IFA.
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