Recorded presentation

Ayman El Mohandes, MD, MPH, FAAP, School of Public Health and Health Services, George Washington University, 2300 Eye Street, NW, Ross Hall 125-G, Washington, DC 20037, 202 994 3686, sphaxe@gwumc.edu, Lamiaa Mohsen, MD MSc, PhD, Perinatal Coordinator, John Snow, Inc, 21 Misr Helwan Agricultural Road, 10th floor, Maadi, Cairo, Egypt, Esmat Mansour Ibrahim El Sharkably, MD, MSc PhD, Ministry of Health/ HM-HC Project, 21, El Saba3 Sakkayat St., Kasr El Eini, Kasr El Aini, Cairo, Egypt, and Reginald F. Gipson, MD, MPH, Healthy Mother/Healthy Child, John Snow, Inc., 21 Misr Helwan Agricultural Rd., 10th floor, Maadi, Cairo, Egypt.

The resources and skills involved in the care of low birth weight and preterm infants represents a greater challenge to the targeted neonatal care units when compared to full term neonatal admissions. An initial trial of introduction of ventilation care to the neonatal units in Egypt was not met with the degree of success anticipated. The skill level of the physicians and nurses, as well as the necessary supportive technology, became obstacles in implementing ventilation care in many of the units. In 2002 the Healthy Mother / Healthy Child neonatal consultation group came to the conclusion that a less technologically-intensive modality of respiratory care would be more appropriate for these units. As a consequence, a pilot program was started in seven neonatal care units in Upper Egypt. The seven units showed a degree of "Excellence" and were therefore chosen to receive the pilot NCPAP training. The survival rate in 2002 (before the implementation of NCPAP) was 82% for preterm infants between 1500-2499 and 51% for those weighing less than 1500 grams. These rates improved in 2003 (after the implementation of NCPAP) to reach 87% and 73% for the same weight categories.These results emphasized the importance of generalizing the implementation of the NCPAP modality of therapy nation-wide as it has the potential to markedly improve the survival rate in this high-risk group.

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