Interventions for Preterm birth complications

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Age Cohort: Pregnancy and newborn

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Education of pregnant women on importance of early registration for antenatal care Education of pregnant women on signs and symptoms of labor Education of pregnant women on what to do when signs and symptoms of labor occur Education on Kangaroo mother care and Kangaroo Father care	Education of pregnant women on dangers of alcohol, smoking and use of recreational drugs during pregnancy Referral of pregnant women to next level for early dating of pregnancy Education of pregnant women and their families on birth preparation and complication readiness Urgent Referral of pregnant women with signs of premature labour to a health facilty for management		Examination of all babies delivered in the community for signs of prematurity, especially when gestational age is unknown Referral of babies delivered preterm and those suspected to be preterm to next level for assessment and management	Follow up of babies delivered preterm who have been discharged home for monitoring of neurodevelopmental milestones Education of mothers on care of preterm neonates including Kangaroo Mother Care	Psychosocial support of mothers with premature births and their families Counselling Spiritual support
Primary Care
Education of pregnant women on signs and symptoms of labor Education of pregnant women on what to do when signs and symptoms of labor occur Provision of antenatal care for all pregnant women with screening for pre-eclampsia and other risk factors for preterm labor	Education of pregnant women on dangers of alcohol, smoking and use of recreational drugs during pregnancy Education of pregnant women and their families on birth preparation and complication readiness Early establishment of gestational age in all pregnancies to hospital for further management Referral of women in early stages of preterm labor to hospital for management and delivery		Referral of all preterm deliveries to hospital for further management Early drying of all babies with extra coverings for preterm babies to prevent hypothermia	Follow up of babies delivered preterm who have been discharged home for monitoring of neuro developmental milestones Education of mothers on care of preterm neonates including Kangaroo Mother Care	Psychosocial support of mothers with premature births and their families Counselling Spiritual support
Referral Facility: General
Health education to communities and to mothers on preterm birth complications including prevention measures Education of pregnant women on signs and symptoms of labor Education of pregnant women on what to do when signs and symptoms of labor occur Provision of antenatal care for all pregnant women with screening for pre-eclampsia and other risk factors for preterm labor Education on Kangaroo mother care and Kangaroo Father care	Clinical and physical examination Administration of tocolytic agents to women 34 weeks or less in early preterm labour Administration of corticosteroids to women in preterm labour who are 34 weeks or less Have a neonatologist or a doctor with experience in neonatal care present to handle neonatal resuscitation during all preterm deliveries Nutritional support for premature babies High dependency unit services for premature babies Neonatal ICU services for premature babies Transfer all preterm babies to neonatal intensive care unit after delivery for assessment		Physical and Clinical examinations Assessment and follow up of preterm neonates for complications of prematurity Appropriate treatment of any detected complications of prematurity Intravenous or gavage feeding of preterm neonates born before 34 weeks Gradual transition of preterm neonates from intravenous or gavage feeding to breastfeeding Education of mothers on care of preterm neonates including Kangaroo Mother Care Use of Kangaroo Mother Care especially in hospitals without neonatal intensive care facilities and during period of observation before discharge	Follow up of babies delivered preterm who have been discharged home for monitoring of neuro developmental milestones	Psychosocial support of mothers with premature births and their families Counselling Spiritual support
Referral Facility: Specialist
Health education to communities and to mothers on preterm birth complications including prevention measures Education of pregnant women on signs and symptoms of labor Education of pregnant women on what to do when signs and symptoms of labor occur Provision of antenatal care for all pregnant women with screening for pre-eclampsia and other risk factors for preterm labor Education on Kangaroo mother care and Kangaroo Father care	Clinical and physical examination Administration of tocolytic agents to women 34 weeks or less in early preterm labour Administration of corticosteroids to women in preterm labour who are 34 weeks or less Neonatal resuscitation for preterm deliveries by a qualified personeel (neonatologist) Nutritional support for premature babies High dependency unit services for premature babies Neonatal ICU services for premature babies Transfer all preterm babies to neonatal intensive care unit after delivery for assessment		Physical and Clinical examination Assessment and follow up of preterm neonates for complications of prematurity Appropriate treatment of any detected complications of prematurity * Intravenous or gavage feeding of preterm neonates born before 34 weeks Gradual transition of preterm neonates from intravenous or gavage feeding to breastfeeding Education of mothers on care of preterm neonates including Kangaroo Mother Care Use of Kangaroo Mother Care especially in hospitals without neonatal intensive care facilities and during period of observation before discharge	Follow up of babies delivered preterm who have been discharged home for monitoring of neuro developmental milestones	Psychosocial support of mothers with premature births and their families Counselling Spiritual support

Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
				Follow up of babies delivered preterm who have been discharged home for monitoring of neuro-developmental milestones
Primary Care
				Follow up of babies delivered preterm who have been discharged home for monitoring of neuro developmental milestones
Referral Facility: General

Referral Facility: Specialist

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community awareness on the need for regular ANC and skilled birth attendance * Promote good maternal nutrition/including nutritional supplementation	Regular ANC attendance Delivery by a skilled attendance Timely access to obstetric care Smoking cessation Maintain healthy body weight Avoidance of heavy workload	Recognition of neonatal preterm birth signs and symptoms	Immediate Kangaroo mother care (KMC) Immediate transfer to a higher-level health care facility	Psychological support to parents of babies with birth-related complications
Primary Care
Family involvement in the routine care of preterm or low-birth-weight infants in health-care facilities	Identify high risk women Antibiotics for PROM Timely referral	History Physical examination Pelvic examination	Immediate Kangaroo mother care (KMC) Expressed mother’s own milk feeding by cups, nasogastric tubes Immediate transfer to a higher-level health care facility
Referral Facility: General
Family involvement in the routine care of preterm or low-birth-weight infants in health-care facilities	Manage pre-eclampsia correctly Corticosteroids Tocolytics Magnesium sulphate Antibiotics for PROM	History Physical examination Pelvic exam Transvaginal ultrasound Transabdominal ultrasound scan	Immediate Kangaroo mother care (KMC) Expressed mother’s own milk feeding by cups, nasogastric tubes Enteral iron supplementation Continuous positive airway pressure (CPAP) therapy Caffeine or other methylxanthines (aminophylline or theophylline)	Physical therapy for children with neurological complications Education and counselling support to families to care for their sick, vulnerable, preterm or LBW infant
Referral Facility: Specialist
Family involvement in the routine care of preterm or low-birth-weight infants in health-care facilities	Manage pre-eclampsia correctly Corticosteroids Tocolytics Magnesium sulphate	History Physical examination Pelvic exam Non-stress cardiotocography Tocography Transvaginal ultrasound of the cervix Cervico-vaginal swab for foetal fibronectin	Immediate Kangaroo mother care (KMC) Expressed mother’s own milk feeding by cups, nasogastric tubes Enteral iron supplementation Continuous positive airway pressure (CPAP) therapy Caffeine or other methylxanthines (aminophylline or theophylline)	Physical therapy for children with neurological complications Education and counselling support to families to care for their sick, vulnerable, preterm or LBW infant