Treating newborn sepsis where referral is not an option: the case of DRC
The Ministry of Public Health in DRC along with the Direction de la Santé de la Famille et de Groupes Spécifiques just released the results of a study analyzing the bottlenecks related to demand, supply and use of antibiotics for the treatment of neonatal sepsis in the DRC.
The newborn mortality rate in the DRC remains high at 30 per 1,000 live births, with neonatal sepsis one of the main causes of neonatal mortality. While national policy recommends management of neonatal sepsis through hospitalization and a combination treatment of three injectable broad-spectrum antibiotics, this recommendation is often not implemented: most families in poor communities do not accept the referral to the hospital because of the distance to the hospital and the cost of this care, among other factors.
This study, funded by the UN Commission on Life-Saving Commodities, comes on the heels of the African Neonatal Sepsis Trial (AFRINEST) which was conducted jointly in the DRC, Nigeria, and Kenya and demonstrated that, where referral to hospital was not possible, the treatment of sepsis cases in the newborn was possible with oral amoxicillin for seven days, combined with gentamicin injections.
The current study was conducted in four health zones: Bominenge (South Ubangi), Karawa (North Ubangi), and Kadutu and Bagira (South Kivu). Bottlenecks identified through this study revolve mainly around the weakness of the essential medicines supply chain, which causes the unavailability of antibiotics for neonatal sepsis at health facilities; the inadequate training of health care providers on the application of standards and guidelines for management of neonatal sepsis and administration of injectable antibiotics; the high cost of antibiotics for neonatal sepsis; and the low awareness of targeted groups of the danger signs.
Specific recommendations to increase access and use of antibiotics to treat newborn sepsis conclude the study. These include: updating and harmonizing standards and guidelines; training health care providers in applying those standards and guidelines; expanding demonstration sites for the simplified regimen of newborn sepsis treatment; strengthening supply; and raising community awareness about the danger signs and the importance of seeking treatment for newborn sepsis.
The study was funded by the UN Commission on Life-Saving Commodities.
Download the study here in English and French