Disinfection of Neonatal Resuscitation Equipment in Low-Resource Settings: The Importance, the Reality, and Considerations for the Future

Anne M. White, Dominic Mutai, David Cheruiyot, Amy R. L. Rule, Joel E. Mortensen, Joshua K. Schaffzin and Beena D. Kamath-Rayne
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Anne M. White: University of Minnesota Masonic Children’s Hospital, University of Minnesota, Minneapolis, MN 55454, USA
Dominic Mutai: Tenwek Hospital, Bomet 20400, Kenya
David Cheruiyot: Tenwek Hospital, Bomet 20400, Kenya
Amy R. L. Rule: Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
Joel E. Mortensen: Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
Joshua K. Schaffzin: Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
Beena D. Kamath-Rayne: American Academy of Pediatrics, Itasca, IL 60143, USA

IJERPH, 2021, vol. 18, issue 13, 1-12

Abstract: Preventable neonatal deaths due to prematurity, perinatal events, and infections are the leading causes of under-five mortality. The vast majority of these deaths are in resource-limited areas. Deaths due to infection have been associated with lack of access to clean water, overcrowded nurseries, and improper disinfection (reprocessing) of equipment, including vital resuscitation equipment. Reprocessing has recently come to heightened attention, with the COVID-19 pandemic bringing this issue to the forefront across all economic levels; however, it is particularly challenging in low-resource settings. In 2015, Eslami et al. published a letter to the editor in Resuscitation , highlighting concerns about the disinfection of equipment being used to resuscitate newborns in Kenya. To address the issue of improper disinfection, the global health nongovernment organization PATH gathered a group of experts and, due to lack of best-practice evidence, published guidelines with recommendations for reprocessing of neonatal resuscitation equipment in low-resource areas. The guidelines follow the gold-standard principle of high-level disinfection; however, there is ongoing concern that the complexity of the guideline would make feasibility and sustainability difficult in the settings for which it was designed. Observations from hospitals in Kenya and Malawi reinforce this concern. The purpose of this review is to discuss why proper disinfection of equipment is important, why this is challenging in low-resource settings, and suggestions for solutions to move forward.

Keywords: neonatal mortality; neonatal infection; reprocessing; disinfection; global child health (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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