THERMAL CONTROL OF THE NEWBORN - KNOWLEDGE AND PRACTICE OF HEALTH-PROFESSIONALS IN 7 COUNTRIES

Hypothermia is a common problem in neonates, particularly in developin g countries where it is an important contributory factor to neonatal m ortality and morbidity. An evaluation of the knowledge and practices o f health professionals on the thermal control of newborns was carried out in seven countries: Brazil, India, Indonesia, Kazakhstan, Mozambiq ue, Nepal and Zimbabwe. The evaluation, conceived as a preliminary pha se for a one-day training course on thermal control, involved 28 healt h facilities and 260 health professionals (61 doctors and 199 nurses a nd midwives). It included an assessment of thermal control practices c arried out in each health facility by external investigators and a que stionnaire on knowledge about thermoregulation administered to health professionals involved in newborn care. The findings of the evaluation were consistent across countries and showed that thermal control prac tices were frequently inadequate in the following areas: ensuring a wa rm environment at the time of delivery; initiation of breastfeeding an d contact with mother; bathing; checking the baby's temperature; therm al protection of low birth weight babies, and care during transport. K nowledge on thermal control was also insufficient, especially concerni ng the physiology of thermoregulation and criteria for defining hypoth ermia. During the one-day course that followed the evaluation, partici pants were able to recognize the existing gaps and to identify appropr iate interventions. :Knowledge and:practice on the thermal control of the newborn are currently insufficient. However, awareness of the impo rtance of thermal control and basic knowledge on thermal regulation an d thermal protection can be easily acquired and on this basis motivati on for improving thermal control practices can be developed.