1. Dr. Farah Fatupaito PRSH Conference Samoa 2013

3.  2 main- Upolu  1 main Savaii  8 district hospitals  Experienced Midwives in each hospital  All sick newborns referred to Tupua Tamasese Meaole Hospital

5.  neonatal health issues  Mortality rates  Progress to achieving MDGs of reducing child mortality  Strategies to achieving MDG 4  Challenges and opportunities to improve services

7.  Respiratory tract infections  Acute gastroenteritis  Low birth weight babies and congenital abnormalities  Malnutrition  Rheumatic fever  Iron deficiency anemia  Breast feeding  Immunization coverage

8. 1Pneumonia 2Acute bronchiolitis 3Acute gastroenteritis 4Typhoid fevers 5Infections of the skin/ subcutaneous tissues 6Injuries, wounds, fractures, poisoning 7Aspiration syndromes ( meconium ) 8Bacterial sepsis of the newborn 9prematurity / Low birth rates 10Asphyxia / fetal distress 10 leading causes of hospital morbidity 0-13 years FY 07/08

9. Total number of admissions to NNU  2009 -823  2010 - 911  2011 - 806  2013 -1020 Number of deliveries at TTM  2009-3490  2010- 3057  2011- 3972  2012- 4012

17. Conditions

18.  RESUSCITATION  FLUID AND ELECTROLYTE mx  Prevention and treatment of INFECTION  Long stays in NNU

19. Rates  2009- 5%  2010- 6.8%  2011- 3%  2013-4%

21. Years precedin g SDHS Neonatal mortality Post neonatal mortality Infant mortality Child mortality Under five mortality 0-4 5596 15 5-9 6 3 9 413 10- 14 538412 Source :Samoa Demographic Survey

25. Years preceding SDHS Neonatal mortality Post neonatal mortality Infant mortality Child mortality Under five mortality 0-4 5596 15 5-9 6 3 9 413 10- 14 538412 Source :Samoa Demographic Survey

26.  Samoa  Tonga  Fiji  Tuvalu  Kiribati  PNG  Solomon Is  micronesia  8  14  19  23  11  17

28. Goal 4: Reduce child mortality  TARGET Reduce child mortality by 2/3 between 1990 and 2015  INDICATORS Under five mortality rates Infant mortality rates Proportion of 1 year old children immunised against measles

31. Seven essential service Package for child survival Skilled attendance during pregnancy, delivery and immediate postpartum Care of the newborn Breastfeeding and complementary feeding Micronutrient supplementation Immunization of children and mothers Integrated management of sick children 4

33.  Bubble CPAP 2009- improve survival rates in LBW  POINTS training for nurses 2012-2013  Protocols  Visiting Neonatologist Specialists  Medicines eg. surfactant, probiotics,  Newborn screening tests  Annual neonatal resuscitation courses

34.  Prematurity and complications  Meconium  Big babies  Congenital abnormalities  Home deliveries  Staff turnovers  Need for specialisation in neonatal nursing  Early referrals from TBA  Continuous training- Newborn resus/care  Better antenatal care  Equipments for new hosp?  research