754 - A Tailored Multidisciplinary Program in Neonatal Intensive Care Units (NICUs) in Governmental Hospitals (GH) of a Low-Middle Income Country (LMIC)

Publication Number: 754.3840

Angela Massouh, American University of Beirut, Beirut, Beyrouth, Lebanon; Faouzi Maalouf, American University of Beirut, Beirut, Beyrouth, Lebanon; Mohamad El-Khatib, American University of Beirut Medical Center, Beirut, Beyrouth, Lebanon; Hisham Issam. Bawadi, American University of Beirut Medical Center, Beyrouth, Beyrouth, Lebanon; Grace Abdel Nour, American University of Beirut Medical Center, Beirut, Mont-Liban, Lebanon; Aimee Bechara. Khaled, American University of Beirut Medical Center, Beirut, Mont-Liban, Lebanon; Tania K. Daaboul, AUB, Beirut, Beyrouth, Lebanon; Kyaw Aung, UNICEF, Monteverde, Mont-Liban, Lebanon; Sabeen Abdul Sater, Unicef, Iaat, Baalbek-Hermel, Lebanon; Pascale Nakad, American University of Beirut, Beirut, Mont-Liban, Lebanon; Ghinwa Abdallah, American University of Beirut, Beirut, Beyrouth, Lebanon; Khalid Yunis, American University of Beirut, Beirut, Beyrouth, Lebanon

Background: Prematurity and neonatal mortality (NM) are global public health challenges, in LMICs. In Lebanon, NM rates reached 10.7 deaths per 1,000 live births in 2022. Healthcare disparities are more pronounced in remote hospitals, particularly in the realm of newborn care. An assessment of GH NICUs revealed dire needs including lack of evidence based (EB) neonatal care policies, need for specialised healthcare provider training, and lack of specialised medical services and necessary equipment

Objective: A national training program was designed to enhance critical competencies of healthcare providers as well as standardise quality of newborn care in peripheral GH in Lebanon. The program integrated EB practices in neonatal critical care focusing on neonatal resuscitation, infection prevention, and breastfeeding support

Design/Methods: The program, led by the National Collaborative Perinatal Neonatal Network in partnership with UNICEF, was implemented in 4 peripheral GH in Lebanon. A 2-day training program designed specifically for each, based on a standardised needs assessment to enhance previously identified critical competencies of nurses as well as standardise quality of newborn care. We utilised a multidisciplinary approach whereby training sessions combined theoretical knowledge with practical skills through simulation and hands-on rotations. Tailored theoretical and clinical training on newborn care was provided to 38 nurses, 18 of which sat for a Neonatal Resuscitation Course [NRC]

Results: The effectiveness of the program was evaluated through pre- and post-training assessments, as well as monitoring changes in clinical practices and newborn health outcomes. A 32% improvement in pre and post test scores was found [Pretest mean 57.32  13.19 versus Posttest mean 90.05  7.32; t = -13.635. p < 0.001]. As for the NRC, there was 13% improvement from the baseline. Findings of clinical rounds suggest significant improvements in healthcare professionals' confidence and competency levels, as well as better management of newborns in remote facilities

Conclusion(s): This national program demonstrates potential for tailored training programs to bridge skill gaps and improve quality of newborn care in underserved areas, ultimately contributing to enhanced health outcomes for vulnerable populations. Continuous monitoring on outcome indicators is in process to affirm the impact of the training with the ultimate goal of translating knowledge into practice. Plans are underway to ensure program sustainability by adapting it so that it remains viable given the volatile political situation in Lebanon