(Seychelles News Agency) - The Seychelles health ministry is taking steps to boost the knowledge and skills of professionals working in neonatal care as well as working on establishing new guidelines that correspond to international standards in neonatal resuscitation.

Considered a vital emergency skill when needed, neonatal resuscitation is simply a medical intervention after the birth of a child to help the baby to breathe and if necessary help its heart to beat. 

While the majority of childbirths occur without any hitches, the process can be complicated at times as the transition from the mother’s womb to the external environment brings about significant changes.

The Indian Ocean archipelago of 115 islands with a population of around 90,000 people recorded 1,566 live births in 2013.

According to the National Bureau of Statistics record, the number of infant deaths under one year out of every 1,000 live births (otherwise known as the infant mortality rate) topped 18.5 in 2013, which was the highest recorded in the last five years - the number of babies that died before reaching 7 days old out of every 1,000 babies born alive (early neonatal mortality rate) was 10.2.

In an interview with SNA this week, the Principal Nursing Officer for Specialised Care Nursing at the Seychelles Hospital, Gylian Mein said that the ministry of health had conducted a “situation analysis” on the high infant mortality rate in 2013, which has helped the ministry to identify its strengths and weaknesses.

While the analysis concluded that the deaths were related to various social factors leading to premature births and consequent infections, as well as many babies being born with congenital heart problems, it also noted a lack of standards in the manner in which newborns were handled, with health care providers in the country using a variety of different methods of care.

Although the mortality rate dropped drastically to 10.9 percent in 2014, one area where many neonatal staff expressed a desire to obtain further training was in neonatal resuscitation, although Mein told SNA resuscitation issues represented “only a minority of the deaths.”

Three doctors from the Centre of Perinatal Studies of the Indian Ocean, based in Reunion Island, were in Seychelles last week working with Seychellois health professionals and passing on knowledge on the primary care of newborns, particularly in neonatal resuscitation. 

Some 40 post-natal and labour room midwives, doctors including obstetricians, paediatricians and others who work closely with new-born babies such as the neonatal intensive care unit staff took part in the training.

“While this training has served as a refresher course for paediatricians, it has equipped midwives and obstetricians with previously lacking skills,” said Mein.

Professionals from Reunion island passing on neonatal care techniques to Seychellois health professionals which included post-natal and labour room midwives, doctors including obstetricians, and paediatricians. (Ministry of health) Photo License: CC-BY

Dr Mederic Descoins, who was the main coordinator of the training, told SNA that the training had a greater practical aspect, as providing better care to newborns is mainly a question of "technical skills and good decisions."

“We mainly focussed on building tools to help to prepare equipment and to anticipate the resuscitation of newborns. The practical part was focussed on the primary care and the initial steps of resuscitation: ventilation and cardiac massage,” said Descoins in an email interview.

According to the World Health Organisation, WHO, while most babies breathe spontaneously at birth it is estimated that 10 percent of the babies born annually require assistance to breathe with less than 1 percent needing extensive resuscitation

With the first few minutes of a newborn's life being the most critical, good and effective neonatal resuscitation care is considered to be essential in preventing lifelong consequences.

The training has been conducted as part of a Memorandum of Understanding which the Seychelles health ministry signed with the Medical University Centre of La Réunion which has unfolded in cooperation in various areas of the health sector.

Mein describes the focus on the need for teamwork as an important outcome of the one-week training.

“Now that everyone is equipped with the same skills, a communication channel will be established to clearly identify the responsibility of each personnel in the absence of another. And when the complete team is present there will one person to lead the resuscitation team according to a ‘check-list’ of international standards that will be drawn up,” said Mein.

“That is why we need to once and for all revise our guidelines and establish new ones as well as re-look at our equipment used during neonatal resuscitation to meet international norms,” said Mein.

A second training is expected to take place in December, which according to Dr Descoins will be focussed mainly on the last steps of the resuscitation cares.