2025-02-14 / News
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The quality of neonatal healthcare varies not only between countries but also between healthcare facilities within the same country. The neonatal mortality rate differs significantly across Europe, highlighting the need for universal care standards to ensure high-quality care everywhere. Moreover, the implementation of good care standards reduces inequalities in access to healthcare. The European Standards of Care for Newborn Health (ESCNH) provide such guidelines, yet their practical implementation remains challenging. Many healthcare providers do not perceive the need for change. Here the development of the new self-assessment tool comes into play. This is where the new self-assessment tool comes into play. As a free and easy-to-use resource for healthcare professionals, it will help identify areas requiring improvement and thereby support the implementation of the ESCNH.
Significant disparities exist across Europe in the quality of healthcare for infants born too soon (<37 weeks of gestation) or too small (<2,500g birth weight). The rates of preterm and low birth weight vary considerably across the continent, reflecting inequalities in access to adequate healthcare. The care of these vulnerable infants is associated with high economic expenses and often has lasting medical and social consequences throughout their lives. However, the quality of care differs not only between countries but also within them. Different clinics and hospitals may provide significantly different quality of neonatal care. Consequently, the place of birth can have a profound impact on lifelong health outcomes.
One way to address these inequalities is through the establishment and implementation of universal care standards. This is why the European Foundation for the Care of Newborn Infants (EFCNI) initiated the ESCNH. These ninety-six evidence-based care standards cover healthcare from before birth through to follow-up care for preterm and low birth weight neonates. Their objectives are to improve the quality of care, ensure equal access to optimal healthcare, reduce cultural barriers in treatment, and pave the way for national adaptation. Stakeholders from thirty-one different countries and diverse backgrounds contributed to the development of the ESCNH.
Despite their benefits, the implementation of the ESCNH remains challenging. Healthcare providers may struggle to recognise the need for change or to assess the extent to which they adhere to the standards. Therefore, a self-assessment tool (SAT) is being developed to help healthcare professionals evaluate the level of ESCNH implementation and identify areas requiring improvement.
Using the eDelphi method followed by a pilot-testing phase, the SAT will be developed as a free, publicly available resource for all healthcare providers. Experts from various European countries and disciplines participate in its creation. Healthcare institutions are encouraged to publish their SAT results to enhance transparency and improve neonatal care provision. The SAT will function as a simple, easy-to-use checklist that can be integrated into daily clinical routines.
The multidisciplinary approach and expert collaboration promise the development of a valuable resource to harmonise high-quality neonatal care across Europe and reduce health-related inequalities for infants and their families.
Paper available at: https://bmjpaedsopen.bmj.com/content/9/1/e003008
Full list of authors: Julia Hoffmann, Sarah Lehmann, Gina Ancora, Helmut Hummler, Nicholas Lack, Dietmar Schlembach, Esther Schouten, Ilaria Simonelli, Ylva Thernström Blomqvist, Eleni Vavouraki, James Webbe, Luc J I Zimmermann, Silke Mader, Isabel Geiger
DOI: doi:10.1136/bmjpo-2024-003008