Christa Van der Walt

Integrative literature review defining evidence-based neurodevelopmental supportive care of the preterm infant.

Neurodevelopmental supportive care (NDSC) is a well-researched topic and extensive evidence is available on its benefits in terms of the outcome for preterm infants. The programs, strategies, and individual elements of NDSC have been evaluated; however, knowledge and implementation of the developmental care approach is fragmented and the evidence base for elements of NDSC that make up the holistic model is not explicitly documented. The aim of this study was to identify and critically appraise the methodologic quality of relevant research studies and synthesize the current best available evidence of NDSC. A comprehensive investigation of NDSC including studies using research methods other than clinical trials may provide a combination of results from several primary studies, therefore an integrative literature review was utilized as the method of choice. Sixteen research articles were found to be of good methodologic quality and level and strength of evidence after critical appraisal. They described or defined the elements of NDSC explicitly. Extraction of data from these articles contributed to the formulation of 25 conclusion statements. Each of these statements could be grouped under 9 categories that resulted from a process of synthesis, and each of these categories could be substantiated from its literature support, clinical impact, and supporting evidence, including the specific literature references and volume and level of evidence associated with that element of NDSC, providing the evidence base for defining NDSC.

Health care professionals' perspectives on the requirements facilitating the roll-out of kangaroo mother care in South Africa

This Focused Strategic Assessment (FSA) conducted in September-October 2016 serves as the final evaluation of the Saving Mothers and Newborns in Communities (SMNC) project implemented in Balochistan Province Pakistan. The FSA provided an opportunity to take stock of accomplishments to date and to listen to the stakeholders at all levels. The FSA report will be used by the following audiences as a source of evidence to help inform decisions about future program designs and policies: in-country partners at the national provincial and local levels; USAID (Child Survival and Health Grants Program [CSHGP] Global Health Bureau USAID Missions) the Maternal and Child Survival Program (MCSP) and other CSHGP grantees; and the international global health community. The five overarching questions addressed in the FSA are: 1. To what extent did the project accomplish and/or contribute to the results (goals / objectives) stated in the Strategic Work Plan? 2. What were the key strategies and factors including management issues and policy environment that contributed to what worked or did not work? 3. Which elements of the project have been or are likely to be sustained or expanded? 4. What are stakeholder perspectives on the overall project implementation the policy forums and the Learning Agenda implementation? 5. Working around strengthening community-based maternal and newborn healthcare provision to what extent has the project been successful? In addition to answering these five questions the FSA also focused on four Learning Agenda themes which were selected jointly with the Balochistan Department of Health (DoH) to provide information needed to improve Community Midwives (CMW) policies and programs. These themes were improving the selection process to more effectively recruit and deploy CMWs; promoting financial self-sustainability for CMWs; ensuring that CMWs provide quality care; and streamlining reporting using mobile phones. (Excerpt)