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Table 6 Actions for reducing deaths and disability in preterm babies.

From: Born Too Soon: Care for the preterm baby

Invest and plan
Assess and advocate for newborn and preterm baby care, mobilise parent power
• Review existing policies and programs to integrate high-impact care for premature babies
• Train nurses for newborn care and include skilled personnel for premature baby care in human resource planning for all levels of the health system where babies are cared for
• Ensure essential equipment and commodities are consistently available
Implement
Seize opportunities through other programs including
For all facility births ensure:
• immediate essential newborn care and neonatal resuscitation if needed
• infection prevention and management
At community level scale up:
• Pregnancy and postnatal home visits, including behaviour change messages for families, as well as identification, extra care and referral for premature babies,
• Breastfeeding promotion through home visits, well baby clinics, baby friendly hospital initiative
Reach high coverage with improved care for premature babies especially
• Kangaroo Mother Care and improved feeding for small babies
• Antenatal corticosteroid use
• Respiratory distress syndrome support, safe oxygen use
• Audit and quality improvement processes
• Provide family support
Where additional capacity consider:
• Additional neonatal care such as CPAP,
• Referral level neonatal intensive care, with safeguards to ensure the poor can also access this care
Careful attention to follow up of premature babies (including extremely premature babies) and early identification of impairment
Inform and improve program, coverage and quality
• Improve the data including morbidity follow up and use this in programmatic improvement e.g. gestational specific survival, rates of retinopathy of prematurity etc.
• Address key gaps in the coverage data especially for Kangaroo Mother Care
Innovate and undertake research
• Establish prioritised research agenda with emphasis on implementation
• Invest in research and in research capacity
• Conduct multi-country studies of effect, cost and "how to" and disseminate findings linked to action
  1. Source: Born Too Soon, Chapter 5 [113].