1. Cooperation To The Development Of Specific Neonatal Care In A Referral Hospital At Douala – Can videoconference increase quality and sustainability?
Flavia Rosa da Silva1, Karin Petitdemange Niederhauser1, Sylvie Loiseau1, Danielle Kedy Koum2, Beat Stoll3, Riccardo E. Pfister1
1 Division of neonatology, Geneva University Hospitals (HUG) , University of Geveva, Switzerland
2 Peadiatric Departement, Gyneco-obstetric and pediatric Hospital of Doula (HGOPED), Cameroon
3 Institute of Global Health, Geneva University, Geneva, Switzerland
Background in facts
North South cooperation programs are expensive (travel and human resources) and challenged by sustainability.
Knowledge and information transfer
Videoconference (VC) is widely used in our Neonatal Unit in Geneva to allow parents close contact to their baby 24h/24.
In developing countries VC has been shown to be useful in nurse education and to increase access to specialized education3; it has also been shown to be effective in assessing resuscitation skills in neonatology4, but questions about sustainability and quality of learning outcomes remain unanswered.
Aim 
To implement a Professional Development Training Program in Neonatology for nurses in a referral hospital (HGOPED-Douala) based on local needs.
It combines:
Classical “on site” approach
Long term follow up : Remote support by Videoconference (VC)
A single on site refresh including an evaluation
For this North-South educational cooperation project specific in Neonatal Care, the use of VC to support and evaluate its success and sustainability is novel.
Videoconference (VC)
The VC application chosen is Avaya Scopia TM, base on our current routine in the Geneva unit and is therefore ready for implementation:
Frequent exchanges between sites: VC-trainings, VC-case presentations…
Remote follow-up and continuous program evaluation: monthly VC-meetings
Development of this skill to allow long term cooperation in the current and future projects
Challenges
Half of the pediatric mortality worldwide is neonatal. In million newborns died, 99% of these in developing countries1.
The main issues were technical:
lack of training,
operational system incompatibility
malfunctioning of the camera
In Cameroon, Neonatal mortality is close to 26/1000 live births, 9 times higher than Switzerland’s1.
The hardware and software issues have been addressed
The training to the local IT focal points will be deployed with implementation
Method
The project consists of 4 phases (needs assessment, planning, implementation, evaluation) with following focus:
Main neonatal killers (neonatal sepsis, birth asphyxia, prematurity & low birth weight)
Basic neonatal nursing skills, ward organization and workflow
Results
In the needs assessment we evaluated training requirements based on focused targets, local staff perception, local practices, epidemiological and observational data.
We successfully tested VC-conferencing between the neonatal unit in Geneva and HGOPED. This was the first VC experience for HGOPED in Douala to operate in VC.
Quality evaluation criteria:
Technical set-up problems: fair
Image Quality: very good
Sound quality: very good
Neonate at HGOPED Cameroon
Conclusions
We expect to demonstrate that VC-conferencing can enhance the performance indicators of a Public Health cooperation program and support its sustainability at reduced costs.
A model guideline and logic framework will be constructed through this project to reproduce an improved template.
Reducing neonatal mortality is one of the targets for the SDG, that counts on lowering this mortality to 12/1000 live births from
Needs assessment
(jan 2018)
VC testing: faisability, reproductibility and potential issues
Identifying VC local focal point
Planification
(feb-jul 2018)
Correct technical problems
Developing VC evaluation tools
Planning of VC trainings
Implementation (nov 2018)
VC training
First VC-sessions with medical staff
M&E (dec )
Monthly neonatal VC-trainings and VC-case discussions
Project follow up VC-meetings
In most health structures in Cameroon, a large portion of neonatal care depends on nurses with little or no specific training in Neonatology. There is no specialized Neonatology training for nurses in the country.
COMPLETED
Nurse, HGOPED Cameroon
References
1. You D, Hug L, Ejdemyr S, et al. Levels and Trends in Child Mortality Report 2015_9_3 LR Web.pdf.
2. WHO. Sdg Health and Health-Related Targets. World Heal Stat :29-41.
3. Chipps J. The use of synchronous videoconferencing teaching to increase access to specialist nurse education in rural kwazulu-natal, South Africa. Knowl Manag E-Learning. 2010;2(2):
4. Cronin CMG, Cheang S, Hlynka D, Adair E, Roberts S. Videoconferencing can be used to assess neonatal resuscitation skills. Med Educ. 2001;35(11): doi: /j x.
ONGOING
Conference Room HGOPED, Cameroon Images to be projected on the wall
COMING SOON
Conference Room Neonatology – HUG, Switzerland
COMING SOON