WIP 63 - Impact of a Designated Assessment and Resuscitation Team (DART) in regional, referral hospitals in Ghana to improve neonatal outcomes.

Poster Number: WIP 63
Publication Number: WIP 63.854

Background: Globally, approximately 10 million babies require resuscitation at birth. In Ghana, training in Helping Babies Breath and Essential Care for Every Baby at regional hospitals (2013-2018) did not result in sustained improvements in neonatal care. Significant gaps remained due to shortages of personnel, frequent staff rotations, and limited continuing education resulting in poor quality newborn resuscitation and postdelivery care. A Designated Assessment and Resuscitation Team (DART) was conceptualized as a method to improve high quality and focused care to at-risk newborns during delivery, resuscitation, intra-hospital transport and postnatal evaluation. DART is a part of the Making Every Baby Count Initiative (MEBCI) 2.0 (2020-2024) to strengthen newborn care at regional hospitals in Ghana through clinical training, quality improvement, and leadership engagement.

Objective: To determine the impact of DART on neonatal mortality, asphyxia, and admission rate to NICU in regional hospitals in Ghana.

Design/Methods: The DART team consisted of midwifes, neonatal and pediatric nurses with experience in the labor ward, operating theatre and NICU. Training included (a) Neonatal Resuscitation Program (AAP, 7th edition); (b) transport of high-risk neonates; and (c) postnatal newborn examination and evaluation. Monthly meetings were held virtually to review progress and barriers to improvement and implementation. A WhatsApp group was set up for regular communication and problem solving in each facility. Outcome data include number of NICU/Baby Unit admissions, the number of still births, and neonatal mortality. Secondary outcomes currently being studied include: NICU/Baby Unit admissions for asphyxia; admissions for respiratory distress among full-term infants. Outcome data collected during this period is compared with data prior to the initiation of DART.