Oxygen and supportive care
Major improvements to neonatal outcomes can occur by
standardising provision of neonatal care in rural and district
hospitals. In the Eastern Highlands of Papua New Guinea,
where general improvements were made to neonatal care
(better provision of oxygen, detection and treatment of
apnoea, thermoregulation, detection and treatment of hypoglycaemia,
protocols for the safe use of intravenous fluids,
and improved nutrition), case fatality from pneumonia was
more than 50% lower during a 30 month period after the
interventions compared with the 30 months before.47
Mortality also fell from other causes, particularly low birth
weight, emphasising the values of a syndromic approach and
general supportive measures rather than a diagnosis specific
approach to neonatal care. These improvements occurred
while WHO standard antibiotic treatment regimens were
used throughout the two periods of study, and apart from
oxygen and pulse oximetry did not require any intensive
technologies