Document Detail

Early postnatal assessment of the newborn in the developing country: Malawi.
MedLine Citation:
PMID:  8286766     Owner:  NLM     Status:  MEDLINE    
The high rate of infant mortality, defined as the number of deaths in the first year of life for every 1000 babies born alive (WHO, 1981), is recognized as an extremely serious problem in the developing world. Worldwide decreases in the number of infant deaths are occurring; however, the gap continues to increase in countries with high socioeconomic baselines and those with low per capita income. This article discusses ways in which relevant health care policies and the use of newborn assessment tools can decrease infant mortality in Malawi Central Africa. The description of the tool, Newborn History and Physical Examination Form, for assessing the newborn and documenting care from birth until discharge in this setting, is included. Post delivery care and the components of a history and physical examination are amplified.
In Malawi, 42 of every 1000 infants born in a hospital die within the first 28 days of life. Malawi has the sixth highest infant mortality rate (IMR) in the world (151/1000 live births). The IMR is likely to be an underestimate, however, since Malawi has no mechanism to record births and deaths outside health facilities and even documentation within health facilities is incomplete. To decrease infant mortality and morbidity, health professionals first need to identify the status of newborns. To do this, however, data collection is needed to make such a diagnosis. The simple, yet thorough infant assessment tool, Newborn History and Physical Examination Form, delineates the parameters of a healthy newborn. The findings of infant assessments should help parents and health personnel make decisions about newborn care. The tool also serves as a baseline for future health care and to facilitate parent reassurance and education. It was designed for settings where little technology is available, such as Malawi. It is based on development and nursing theories, accepted practice, and standards of maternal-child health care. The components of the physical assessment include information on stool, urine, feeding, temperature, weight, respiratory status, umbilical stump, muscle tone, apical pulse, and skin color. A review of maternal records for the prenatal, intrapartum, and postnatal course is also part of the tool. An interval history is part of the infant assessment, which can be recorded with a flow chart. Breast feeding patterns, temperature, condition of eyes, umbilical stump, stools, urine, and mother's concern or questions comprise the interval history. A gestational aging guide should be posted on the wall so nurses can easily determine gestational age. The last part of the infant assessment is discharge information.
M Heymann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The ABNF journal : official journal of the Association of Black Nursing Faculty in Higher Education, Inc     Volume:  4     ISSN:  1046-7041     ISO Abbreviation:  ABNF J     Publication Date:  1993  
Date Detail:
Created Date:  1994-02-24     Completed Date:  1994-02-24     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9112807     Medline TA:  ABNF J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  90-4     Citation Subset:  J; N    
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MeSH Terms
Developing Countries*
Infant Mortality
Infant, Newborn
Malawi / epidemiology
Neonatal Nursing*
Nursing Assessment*
Nursing Records
Postnatal Care*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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