Newborn transfer within institutions and between different institutions
The equipment used in transport must comply with several general characteristics:
• Appropriate for the age group and for the health problems to be managed.
• Lightweight, portable, rugged and easy to clean
• It must be securely fastened in the transport vehicle for patient and equipment safety.
• Tested in transport conditions (temperature, altitude, vibration).
It is essential to have equipment that allows for:
As efforts to improve the outcomes of neonatal survival are scaled up, there is an increased demand for access to safe and effective transport.
Improving the procedures related to neonatal transport and the quality of care in critical conditions requires evidence-based technical guidelines as a reference for agencies, facilities, and health professionals responsible for setting health system priorities and policies around newborn transport.
Regionalization poses the challenge of defining where to assign resources to intensive care, transport or prevention and primary care.
Neonatal transport should be seen in the context of regionalized perinatal care, which encompasses the care of the pregnant woman and her fetus, the mother-to-be and her baby.
Before organizing a neonatal transport system, there needs to be planning and coordination at the national and regional levels to align transport goals and objectives with those of the health system as a whole.
The planning process includes:
• Alignment of the objectives aimed to improve health system outcomes and transportation priority cases (and cases excluded).
• Estimation of the demand for care for each health problem selected and per region (met and unmet needs).
Delays in the neonatal transfer system can have an impact on mortality. The “three delays” model (Thaddeus and Maine, 1994) describes a conceptual framework for the factors and phases of delay that influence timely access to specialized emergency care. The model makes it possible to analyze delays in the process at each stage of neonatal transfers.
In most cases, neonates are transferred from a primary care center to a referral center, but it can also occur from the community, from a facility or from within the same center.
Safely transferring sick newborns to health facilities with the level of complexity required to treat their condition contributes to the reduction of neonatal morbidity and mortality rates. Reducing these rates is essential to achieve the global goals for child survival in the coming decades. Efforts to prevent the main causes of neonatal mortality must be complemented by the development of systems to care for sick newborns, including safe neonatal transport.