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This content is taken from the London School of Hygiene & Tropical Medicine's online course, Retinopathy of Prematurity: Practical Approaches to Prevent Blindness. Join the course to learn more.
Looking through the doors to the NICU (with an ROP health awareness poster on the wall) at a mother tenderly holding her baby beside the incubator
Mother caring for her preterm baby in the NICU, Government Hospital, Nalgonda, India

Reflecting on and applying your learning this week

This week we have explored the wide range of multi-sectoral, organisational action that is needed to deliver high quality healthcare services and reduce preterm babies’ risk of developing long term disabilities such as retinopathy of prematurity. These interconnected activities are targeted:

  • Before birth through prevention strategies, planning and organising accessible neonatal services.

  • In the first hour after birth by ensuring a trained team provides the supportive care preterm babies need at delivery and organise transfers as required.

  • Following birth by ensuring all the key care activities for preterm babies are provided within the NICU.

Across all the different stages it’s vital to maintain good communication with families and between different healthcare providers, and to manage data effectively for each preterm baby and across the complex range of services being provided.

Exercise: Prioritise healthcare action to reduce the risks of preterm birth

The table below lists all the healthcare activities we have discussed this week that are known to reduce the risks of preterm birth. To complete the week, use the table to consider what you think the priorities are to improve healthcare services for preterm birth in your setting. To help you, you can download this supporting PDF template.

You can choose to approach this exercise from the perspective of a parent or a healthcare worker. You might find it useful to look back to your quality score for a local neonatal service in step 2.7.

Step 1. For each of the 11 listed activities, consider whether the action is:

  • Done regularly, or
  • Done sometimes, or
  • Never done / Not feasible.

Step 2. Identify what needs to be changed to improve each of the 11 activities in your setting. If you are a healthcare worker, what can you personally do?

Action to reduce risks of preterm birth How often done in my setting? What do we need to change?
Antenatal use of corticosteriods    
Managing the golden hour    
Coordinating transfers in utero and ex utero    
Pain management    
Oxygen management    
Infection control    
Nutrition management    
Temperature management    
Supportive care e.g. Kangaroo care    
Communicating with parents    
Data management    


Which of these activities would you prioritise for change in your setting and how would you go about it? Share your choices and the reasons for them in the Comments.

Week 3

Next week we look in detail at the screening process undertaken to identify and manage ROP in premature babies.

Join our live Q&A session on 7 October 2020

An international panel of ROP experts will tackle complex questions surrounding ROP management and also addressed any other questions you may have as you go through the course content. Please write out your questions in step 3.15 in week 3 as you go along.

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This article is from the free online course:

Retinopathy of Prematurity: Practical Approaches to Prevent Blindness

London School of Hygiene & Tropical Medicine