Interventions for Birth trauma

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Full assessment of any community births with Apgar scores Refer neonates with Apgar score less than 7 to next level for assessment Complete examination of neonates for evidence of birth trauma Confirm spontaneous movement of all limbs and exclude the presence of any head swelling or skull depression		Refer neonates with suspected birth trauma to next level for further assessment	Follow up neonates with residual effects of birth trauma with any needed home based physiotherapy support	Psychological support for families whose neonates with birth trauma including those who have developed permanent nerve injuries
Primary Care
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Full assessment of all newborns with Apgar score Complete examination of neonates for evidence of birth trauma Confirm spontaneous movement of all limbs and exclude the presence of any head swelling or skull depression		Refer neonates with confirmed birth trauma to next level for further assessment and management Safe transpotation of neonates/small babies Encourage KFC AND/or KMC Encourage breast feeding/nutritional support	Follow up neonates with residual effects of birth trauma with any needed physiotherapy support Referral of neonates with permanent nerve injuries to hospital for specialist assessment and advice on further management	psychological support for families whose neonates with birth trauma including those who have developed permanent nerve injuries Spiritual support
Referral Facility: General
			Clinical examination Physical examination Nutritional support antibitics terapy where indicated safe transportation of small babies Encourage KFC and /or KMC Refer to specialised hospitals for ICU services where indicated Laboratory services /invstigations that include but are not limited to: blood film microscopy, blood group and cross-match, blood chemistry, CSF and stool and urine microscopy, gram stain, Imaging modalities including x-ray ultra-sound	Health education to mothers on birth trauma and prevention measures Health education on need for ANC attendance Promotion of eraly health seeking behaviour Promotion of facility based deliveries	psychological support for families whose neonates with birth trauma including those who have developed permanent nerve injuries Spiritual support
Referral Facility: Specialist
			Clinical examination Physical examination Nutritional support antibitics terapy where indicated safe transportation of small babies Encourage KFC and /or KMC ICU support where indicated Laboratory services /invstigations that include but are not limited to: blood film microscopy, blood group and cross-match, blood chemistry, CSF and stool and urine microscopy, gram stain, Imaging modalities including x-ray ultra-sound MRI	Health education to mothers on birth trauma and prevention measures Health education on need for ANC attendance Promotion of eraly health seeking behaviour Promotion of facility based deliveries	psychological support for families whose neonates with birth trauma including those who have developed permanent nerve injuries Spiritual support

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Health Education to pregnant women to create awareness on birth trauma Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth trauma including management	Education of mothers on importance of facility delivery, exclusive breastfeeding good hygienic practices		Refer neonates with suspected birth trauma to next level for further assessment	Follow up children with residual effects of birth trauma with any needed home based physiotherapy support Referral of children with permanent nerve injuries to hospital for specialist assessment and advice on further management	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Primary Care
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Check the mother for adequate pelvis, correlate maternal height to pelvis size and refer those in high risk		Refer neonates with confirmed birth trauma to next level Safe transportation of neonates/small babies Kangaroo father care and/or Kangaroo mother care Breastfeeding/nutritional support	Health Education to pregnant women to create awareness on birth trauma Health education to pregnant women on the need for regular ANC and skilled birth attendance Promote early health seeking behaviour Strengthen health workers knowledge on birth trauma including management	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Referral Facility: General
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Check the mother for adequate pelvis, correlate maternal height to pelvis size and refer those in high risk Full assessment of all newborn with Apgar score * Complete examination of neonates for evidence of birth trauma Confirm spontaneous movement of all limbs and exclude the presence of any head swelling or skull depression		Admit to special care baby unit (SCBU) for intensive care management Laboratory services /investigations that include but are not limited to: blood film microscopy, blood group and cross-match, blood chemistry, CSF and stool and urine microscopy, gram stain,	Check the mother for adequate pelvis, correlate maternal height to pelvis size and refer those in high risk * Full assessment of all newborn with Apgar score * Complete examination of neonates for evidence of birth trauma Confirm spontaneous movement of all limbs and exclude the presence of any head swelling or skull depression	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth trauma to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc
Referral Facility: Specialist
Educate pregnant women on the need for facility births attended by a skilled birth attendant	Check the mother for adequate pelvis, correlate maternal height to pelvis size to identify those in high risk (narrow pelvis, big babies, etc.) * Ultrasound examination for gestational age, foetal presentation and foetal weight for early identification		Admit to SBCU for intensive care management Imaging modalities including x-ray, ultrasound, MRI and CT scan Laboratory investigations as indicated * Blood grouping and transfusion if indicated	Psychological support to parents of babies with birth-related complications Follow up neonates treated for birth asphyxia to detect any signs of neurologic dysfunction such as delayed developmental milestones Linkage with rehabilitation centres for physical rehabilitation, speech, etc