A Neonatologist's Experience: From Neonatal Intensive Care Unit to Community Based Newborn Care in an Effort to Save Newborn Lives in Zambia, 1985 to 2011
Abstract
As a young scholar, I looked forward to a fulfilling medical career. Being a paediatrician brought with it the idea of saving lives, the smaller the infant, the greater the achievement, so it seemed. My mentor at the time with the greatest influence on my professional shaping was Professor Chifumbe Chintu, first Zambian Paediatrician, Dean of the School and also head of the Neonatal Intensive Care Unit in C13 and Haematology services for the whole hospital. With this inspiration for a bright and fulfilling career, I set out to train as a paediatrician, with The Royal College of Physicians in the United Kingdom, supported by the Beit Trust. With the further support of my Departmental Head of the department, Prof. Mukelabai, I proceeded to Mie University, Japan where with support from the Japanese International Cooperation Agency, I embarked on my career as a neonatologist in 1989 having worked with newborns from 1985. I was exposed to lifesaving feats in Japan's high technology medical milieu. Infants with necrotizing enterocolitis survived well, while birth asphyxia continued drawing its breath from a ventilator for very long periods. To exemplify this iatrogenic effect of success in the newborn period, I experienced and wondered at a five-year-old child who had been premature at birth, still on the ventilator, with family holding on to hope for more than five years. For me, this was the height of the grip technology on all of us. How far will this go? I have not yet found out, because I remain challenged by the mundane fact that newborns are still dying today, the same if not worse than in the 1980s in my own back yard, and our response is far from adequate1,2. And so my move to the world of preventative care, a stint as Reproductive and Child health advisor at the Ministry of Health and World Health Organisation helped stabilize my understanding of my role in neonatology, child-health and whole care of the child in the family setting.References
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21. Ngoma MPS, Shiferaw T, Mwale R, Mugala N, Mwinga K,Kalesha P, Mbewe RK. 2006. National Position paper on Newborn Health. Ministry of Health
22. Kaseba C 2006. Communication Assessment on Maternal Newborn in Kalulushi and Chipata(Unpublished work ) Presentation at Blue Nile Inn,2006, Alick Nkhata road, Lusaka, Zambia
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24. World Health Organisation /UNICEF , WHO/UNICEF Joint Statement: Home visits for the newborn child: a strategy to improve survival. 2009.
25. Kwapa P, Chela C, Meika R. Implementing home based care in Zambia National AIDS programme. International Conference on AIDS: 1993 Jun 6-11; 9:76.
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27. UNICEF, The State of the World's Children 2008, Chapter 1, page 6
28. Christopher J Gill et al., Effect of training birth attendants on neonatal mortality. Lufwanyama Neonatal Survival Project:randomized study,BMJ2011:342-d346,doi;10.1136/bmj.d346
2. Central Statistical Office (CSO), Central Board of Health, ORC Macro; 2003. Zambia Demographic and Health Survey. 2001 /2. Calverton, Maryland USA: ORC Macro and CSO.
3. Central Statistical Office (CSO), Ministry of Health (MOH),TropicalDiseasesResearchCentre,(TDRC),University of Zambia and Macro international Inc.2009 . Zambia Demographic and Health Survey 2007, Calverton, Maryland, USA:CSO and Macro International Inc.
4. Kyllike Christensson, GJ Bhat, B Eriksson, MPShilalukey Ngoma, G Sterky, Stockholm. 1994. Care of the Newborn Infant : Satisfying the Need for comfort and Energy Conservation. Department of Women and Child Health and International Health and Social Medicine, Unit of international Health Care research(IHCAR), Karolinska Institutet, Stockholm, Sweden, VI:1-V1:10.
5. Mary Shilalukey Ngoma. Providing Quality Paediatric and HIVCare in Resource Limited Settings. Key note address to theZambiaPaediatric AssociationMeeting, 13 November 2010. Golf View Hotel Lusaka, Zambia.
6. MPShilalukey Ngoma, AMushanga, X.Wang and M.Watanabe 1992. Clinical Presentation of HIV/AIDS in the High risk neonate in Zambia, Advances in Perinatal Medicine, Editors: S Sakamoto and YTakeda, Elservier Science Publishers,B.V, 221-224.
7. Lawn JE, Cousens S, Zupan JE. 4 million neonatal deaths: When? Where? Why?Lancet 2005; 365: 891-900.
8. Darmstadt GL, Bhutta ZA, Cousens S, Adam T, and Walker N, Bernis L. Evidence-based, cost-effective interventions: how many newborns can we save? The Lancet Neonatal Survival 2005;19-30.
9. WHO bulletin. 2008. The Global Burden of Disease: 2004 update.
10. UNICEF Press Release: Issued by Udani Samarasekera, press officer. Three out of the Four Million Newborn Babieswhodieeachyearcouldbesaved.www.unicef.org/childsurvival/files/pressreleasetheLancet.pdf. Downloaded July 2011.
11. WHO Statistical Information System (WHOSIS). World Health Organisation. http://www.who.int/whosis/.The Partnership PMNCH Downloaded July 2011.
12. Bang AT, Bang AB, Baitule SB, Reddy MH, Deshmukh. Effect of home based neonatal care and management of sepsis on neonatal mortality: field trail in rural India. Lancet 1999; 354(9919): 1955-61.
13. World Health Organization. 1996. Essential New-born Care: Report of a Technical Working Group, 1994. WHO/FRH/MSM/96.13,Geneva,WorldHealthOrganization.
14. Lawn JE, Cousens S, Bhutta AZ. Why are 4 million newborn babies dying each year?Lancet 2004; 364: 399-40
15. WorldHealthOrganization. 1998. Basic Newborn Resuscitation: Apractical guide. Geneva: World Health Organization.
16. World Health Organization. 1998. The World Health stReport,1998: Life in the 21Century FAVision for all. WHO. Geneva.
17. Philip AGS & Hewitt JR. Early Diagnosis of Neonatal Sepsis. PEDIATRICS Vol. 65 No. 5 May 1980, pp. 1036-1041
18. Bang AT, Bang RA, Reddy MH, Baitule SB, Deshmukh MD, Paul VK, Marshal TFC, Simple Clinical Criteria to IdentifySepsisorPneumonia.2005.SocietyforEducation, Action and Research in Community Health (SEARCH) Report. Gadchiroli (Maharashtra), 442 605, India.
19. Bang AT, Bang RA, Stoll BJ, Baitule SB, Reddy HM & Deshmukh MD. Is Home-Based Diagnosis and Treatment of Neonatal Sepsis Feasible and Effective? Seven Years of Intervention in the Gadchiroli Field Trial 1996 to 2003.JournalofPerinatology(2005)25,S62–S71.doi:10.1038/sj.jp.7211273.
20. Bang AT, Reddy HM, Deshmukh MD, Baitule SB & Bang RA.Neonatal and Infant Mortality in the Ten Years (1993 to 2003) of the Gadchiroli Field Trial: Effect of Home-Based Neonatal Care. Journal of Perinatology. 2005. 25, S92–S107. doi:10.1038/sj.jp.7211277
21. Ngoma MPS, Shiferaw T, Mwale R, Mugala N, Mwinga K,Kalesha P, Mbewe RK. 2006. National Position paper on Newborn Health. Ministry of Health
22. Kaseba C 2006. Communication Assessment on Maternal Newborn in Kalulushi and Chipata(Unpublished work ) Presentation at Blue Nile Inn,2006, Alick Nkhata road, Lusaka, Zambia
23. University Teaching Hospital, Department of Paediatrics and Child Health annual Reports.2006
24. World Health Organisation /UNICEF , WHO/UNICEF Joint Statement: Home visits for the newborn child: a strategy to improve survival. 2009.
25. Kwapa P, Chela C, Meika R. Implementing home based care in Zambia National AIDS programme. International Conference on AIDS: 1993 Jun 6-11; 9:76.
26. E Chomba 2007. Training midwives to save newborn lives. Presentation at a Maternal Newborn Meeting at Pamodzi Hotel, 2007, Lusaka Zambia.
27. UNICEF, The State of the World's Children 2008, Chapter 1, page 6
28. Christopher J Gill et al., Effect of training birth attendants on neonatal mortality. Lufwanyama Neonatal Survival Project:randomized study,BMJ2011:342-d346,doi;10.1136/bmj.d346
Published
2012-03-31
How to Cite
1.
Ngoma M, Nkumbula T. A Neonatologist’s Experience: From Neonatal Intensive Care Unit to Community Based Newborn Care in an Effort to Save Newborn Lives in Zambia, 1985 to 2011. Journal of Agricultural and Biomedical Sciences [Internet]. 31Mar.2012 [cited 31Jul.2025];1(1):47-1. Available from: https://journals.unza.zm/index.php/JABS/article/view/348
Section
Biomedical Sciences
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