PSBI Community of Practice

New Materials

• Using benchmarks to assess progress towards operationalizing PSBI guidelines
• Implementation of the WHO guideline on treatment of young infants with signs of possible serious bacterial infection when hospital referral is not feasible in rural Zaria, Nigeria: Challenges and solutions
• Performance of prediction rules and guidelines in detecting serious bacterial infections among Tanzanian febrile children
• Implementation research to support Bangladesh Ministry of Health and Family Welfare to implement its national guidelines for management of infections in young infants in two rural districts
• Framework to operationalize management of sick young infants with PSBI   English   French
• Keeping young infants healthy: pamphlet for mothers and caregivers.  English   Swahili
• Management of the Sick Young Infant Aged up to 2 Months: Chart Booklet  French
• Management of the Sick Young Infant Aged up to 2 Months: Participant Manual
• Management of the Sick Young Infant Aged up to 2 Months: Facilitator Guide

Making the Case

Infections including pneumonia, sepsis, and meningitis are responsible for 21% of neonatal deaths annually and were responsible for over 550,000 out of 2.6 million neonatal deaths in 2016, nearly all of them occurring in developing countries[i].

The recommended treatment for these sick newborns is referral for hospital treatment with a seven to ten days course of multiple injectable antibiotics. However, experience has shown that most of these children are unable to receive appropriate treatment because the “gold standard” inpatient care is neither possible nor acceptable for many families in resource-poor settings.

In September 2015 WHO published a guideline for managing PSBI in sick young infants when referral is not feasible. The guideline recommends the use of antibiotics for newborns and young infants (0-59 days old) with PSBI in order to reduce mortality. It also provides clinical guidance on the use of safe and effective simplified antibiotic regimens for outpatient treatment of less severe infections and programmatic guidance on the role of community health workers and home visits in identifying signs of PSBI.

A number of countries have introduced this new guideline and few of them such as Ethiopia, Malawi, and Nepal are implementing the guideline at scale. Early implementers have demonstrated that the implementation of the guideline where referral is not feasible has the potential to increase access to PSBI treatment and can contribute to the reduction of neonatal and young infant mortality, reduce inequity in access to care, and provide an opportunity to improve home visits. An operational guide provides practical guidance on how to operationalize the guideline in a program setting as part of the overall newborn and child health strategy.

Connecting

The PSBI online community of practice provides a virtual platform where people can exchange technical knowledge, share resources and experiences, ask and answer questions, and help to connect people who might not ordinarily interact. We host regular webinars on PSBI and an online exchange platform where you will have the opportunity to discuss with leading experts in the topic.

• Webinar: Join us for our next PSBI CoP webinar
• Slides: See slides for previous webinars
• Online exchange: Join our PSBI Community of Practice

Project

Ponya Mtoto: The Ponya Mtoto project in Kenya aims to assist in reducing the number of infant deaths due to possible serious bacterial infection (PSBI) by revising national Integrated Management of Childhood Illness (IMCI) guidelines.

Keeping young infants healthy: pamphlet for mothers and caregivers.  English   Swahili

Resources

The links below lead to pages to help policy makers and program implementers identify strategies and approaches for increasing access to PSBI treatment using the new PSBI guidelines.

• Blog: Integrating Simplified Treatment Regimens to Manage Sepsis in Sick Young Infants
• Guideline English   French, WHO/UNICEF Statement English  French and Operational Guide
• Cochrane Review of Community Based Antibiotics for PSBI
• Resources on the Healthy Newborn Network site
• PSBI Timeline: Identification of needs to generation of evidence for action
• Framework to operationalize management of sick young infants with PSBI English   French
• Implementation research to support Bangladesh Ministry of Health and Family Welfare to implement its national guidelines for management of infections in young infants in two rural district
• Provider performance and facility readiness for managing infections in young infants in primary care facilities in rural Bangladesh
• Caregiver acceptability of the guidelines for managing young infants with possible serious bacterial infections (PSBI) in primary care facilities in rural Bangladesh
• Early implementation of guidelines for managing young infants with possible serious bacterial infection in Bangladesh

Benchmarks

COUNTRY EXPERIENCE: USING A SIMPLIFIED REGIMEN TO MANAGE PSBI WHEN REFERRAL IS NOT FEASIBLE

Referring a sick young infant with possible serious bacterial infection to a higher level of care is not always feasible in resource-limited settings. This map shows progress in operationalizing the guideline for management of sick young infants with PSBI when referral is not feasible. Twenty-three benchmarks described in the Operational Guide were used to track progress. The benchmarks provide information into whether a specific milestone has been fully or partially achieved or not achieved at all. The countries highlighted in dark blue are implementing the new simplified treatment protocol to manage sick infants with PSBI when referral is not feasible thereby increasing access to life saving interventions. As more information from countries is made available the map will be updated.