Maternal, newborn, child and adolescent health

Operationalizing management of sick young infants with possible serious bacterial infection (PSBI) when referral is not feasible in the context of existing maternal, newborn, and child health programmes



It is estimated that as many as 600 000 newborns die each year from serious infection, and that most of these deaths could be averted by preventive measures, timely careseeking, treatment with appropriate antibiotics and follow up. Approximately 10% of newborn infants develop signs of possible serious bacterial infection (PSBI) and require antibiotics.

The WHO guideline Managing possible serious bacterial infection (PSBI) in young infants when referral Is not feasible, released in September 2015, contained new recommendations for outpatient treatment using simplified antibiotic regimens that can increase access to treatment of pneumonia and PSBI in sick young infants when referral is not accepted or not feasible and can reduce inequity in access to care. They will enable many young infants with PSBI who will not reach hospital care to receive lifesaving care at primary health care facilities.

This document addresses need for practical guidance on how to operationalize the guidelines in the context of a country’s ongoing maternal, newborn and child health programmes.

The concept of outpatient treatment of PSBI where referral is not feasible is a recent development in the field; WHO and key partners such as UNICEF, USAID, and Save the Children have developed this guide to help countries prepare to integrate these recommendations into routine care of sick young infants at primary health care facilities and undertake activities in the community to empower and engage mothers and families to improve maternal and newborn health. Integration of management of sick young infants with PSBI where referral is not feasible should also include activities to support and strengthen implementation of interventions across the continuum of care at community, primary health care facilities and referral facilities.

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