Interventions for Neonatal sepsis and infections

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate mothers/fathers and caregivers on signs and symptoms of neonatal infection using job aides Educate mothers/fathers and community on importance of facility delivery, exclusive breastfeeding good hygienic practices, care of the umbilical cord and avoidance of harmful traditional birth practices	Early initiation and exclusive breastfeeding of neonates Appropriate cord care Emphasis on the need for early referral to health facility for every sick young infant	Recognition of Neonatal sepsis signs and symptoms	Early Referral to the next level for neonates suspected with neonatal sepsis Keeping baby warm all times including on the way to hospital		Psychological support from the community to parents of babies with birth-related complications
Primary Care
Educate mothers/fathers and caregivers on signs and symptoms of neonatal infection using job aides Educate mothers/fathers and community on importance of facility delivery, exclusive breastfeeding good hygienic practices, care of the umbilical cord and avoidance of harmful traditional birth practices	Clean delivery practices and handwashing during delivery Appropriate cord care		Clean cord with chlorhexidine antiseptics Refer to hospital if neonate is not improving		Psychological support to parents of babies with birth-related complications
Referral Facility: General
Education of mothers and other care givers about signs and symptoms of neonatal infection Education of mothers on improtance of exclusive breastfeeding Education of mothers and other care givers and good hygienic practices Education of mothers and other care givers on umbilical cord care	Clean delivery practices and handwashing during delivery Appropriate cord care	History Physical examination Complete blood count Blood culture CSF analysis Chest radiography	Antibiotics IV hydration Oxygen support Appropriate feeding including breast feeding Blood products transfusion Vasopressor agents	Physical therapy for children with neurological complications	Psychological support to parents of babies with birth-related complications
Referral Facility: Specialist
Education of mothers and other care givers about signs and symptoms of neonatal infection Education of mothers on improtance of exclusive breastfeeding Education of mothers and other care givers and good hygienic practices Education of mothers and other care givers on umbilical cord care	Start neonates with foul smelling amniotic fluid at birth with antibiotics for anaerobic infections (Clindamycin or Metronidazole) Full blood count, Blood urine and CSF cultures for all neonates with suspicion of sepsis Refer neonates with suspicion of sepsis to next level if facilities for full investigations are not available	History Physical examination Complete blood count Blood culture CSF analysis Chest radiography Computed tomography (CT) Magnetic resonance imaging (MRI)	Start treatment with ampicillin or penicillin G plus an aminoglycoside Add Cefotaxime if meningitis is suspected Treat with appropriate antibiotics based on culture resultsLaboratory services that include but are not limited to Blood Nutritional support. Early initiation and exclusive breastfeeding. Neonatal High dependency unit services Neonatal ICU services

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate mothers/fathers and caregivers on signs and symptoms of neonatal infection using job aides Educate mothers/fathers and community on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord and avoidance of harmful traditional birth practices	Early initiation and exclusive breastfeeding of neonates Appropriate cord care Emphasis on the need for early referral to health facility for every sick young infant	Recognition of Neonatal sepsis signs and symptoms	Early Referral to the next level for neonates suspected with neonatal sepsis Keeping baby warm all times including on the way to hospital	Physical therapy for children with neurological complications	Psychological support from the community to parents of babies with birth-related complications
Primary Care
Educate mothers/fathers and caregivers on signs and symptoms of neonatal infection using job aides Educate mothers/fathers and community on importance of facility delivery, exclusive breastfeeding good hygienic practices, care of the umbilical cord and avoidance of harmful traditional birth practices	Clean delivery practices and handwashing during delivery Appropriate cord care	History Physical examination	Clean cord with chlorhexidine antiseptics Refer to hospital if neonate is not improving	Physical therapy for children with neurological complications	Psychological and social support to parents of babies with birth-related complications Psychological and social support to parents of babies with birth-related complications
Referral Facility: General
Education of mothers and other caregivers about signs and symptoms of neonatal infection using job aides * Education of mothers on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord.	Clean delivery practices and handwashing during delivery Appropriate cord care	History Physical examination Complete blood count Blood culture CSF analysis Chest radiography	Antibiotics IV hydration Oxygen support Appropriate feeding including breast feeding Blood products transfusion Vasopressor agents	Physical therapy for children with neurological complications	Psychological and social support to parents of babies with birth-related complications
Referral Facility: Specialist
Education of mothers and other caregivers about signs and symptoms of neonatal infection using job aides Education of mothers on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord.	Training of health workers on the nine steps on essential newborn care to prevent neonatal sepsis	History Physical examination Complete blood count Blood culture CSF analysis Chest radiography CT scan MRI	Antibiotics IV hydration Oxygen support Blood products transfusion Vasopressor agents		Psychological and social support to parents of babies with birth-related complications