The stepping stones of the Neonatal Transport Service in Sri Lanka…………

The Perinatal Society of Sri Lanka identified the formulation of a comprehensive Neonatal Transport Service as a key priority area in 2013. The President of the Perinatal Society then Dr. Ramya de Silva, Consultant Paediatrician in Charge of the Neonatal Unit at the Lady Ridgeway Hospital for Children (LRH), Colombo invited a team from Oxford to advice, train and contribute to the development of a national policy of the neonatal transport via pilot project based at the Lady Ridgeway Hospital in Colombo.

The team from Oxford comprised of Dr. Charlotte Bennett (Consultant Neonatologist and Transport Lead, John Radcliffe Hospital, Oxford, UK), Dr. Amit Gupta (Consultant Neonatologist, John Radcliffe Hospital, Oxford, UK) and Ms. Catherine Convery (Nurse at the London Neonatal Transport Service and formerly Matron at the Neonatal Unit at John Radcliffe Hospital, Oxford, UK)

The very first workshop to introduce neonatal transport service to Sri Lanka was conducted on the 8th of May 2013. There were 84 participants including Neonatologists, Paediatricians, Post Graduate Trainees in Paediatrics, Medical Officers and Nursing Officers working in NICUs. A core team of 8 nurses and 4 medical officers from the NICU at LRH was trained separately on all elements relating to safe newborn transfers. The programme was supported by the Family Health Bureau, WHO and UNICEF.

Data was collected over the year June 2013 to June 2014 for admissions to the LRH where the newly formed transport service was used. Analysis of this data showed 88% of the retrieved babies had normal temperatures on admission versus 40% in the non-retrieved group. None of the infants in the retrieved group was hypolycemic but 10% of non retrieved babies were.

The data of the pilot project of the neonatal transport was presented at the 2014 annual scientific sessions of the Sri Lanka College of Paediatricians by Dr. Amit Gupta and at the 2014 annual scientific sessions of the Perinatal Society of Sri Lanka by Dr. Ramya de Silva. The project and the results were highly acclaimed by the Paediatric community.

At the Technical Advisory Committee on Newborn and Child, the national body responsible for the care of the newborn and child, the success story of the pilot project was discussed. A decision was taken to roll it out as national service and this was approved by the Secretary to the Ministry of Health at the National Steering Committee meeting on Family Health.

The second training program by the UK team with Dr. Amit Gupta as the Lead Trainer was undertaken in January 2015. Three workshops were held back to back in Colombo, Kandy and Galle. With that the neonatal transport service in the Central and Southern Provinces were commissioned.

The Neonatal Transport forum of the Sri Lanka College of Paediatricians was formed on the 2nd January 2015 under the presidency of Dr. Ramya de Silva with Dr. Amit Gupta as the honorary patron.

A decision was taken by the Neonatal Transport Forum to have a group of master trainers to do the training throughout the country to expedite the commission of neonatal transport service as a national service.

In February 2016 a project proposal to establish a National Neonatal Transport Service was submitted by the Neonatal Transport Forum of the Sri Lanka College of Paediatricians to the Health Sector Development Project (HSDP) under the Innovative Projects funded by the World Bank. The proposal was accepted.

In February 2016 two Training of Master Trainers workshops were held in Colombo and Polonnaruwa by the UK team. These workshops were supported and funded by the ‘Innovative Projects’ of the HSDP. There was representation from SAARC countries, India, Bangladesh, Nepal and Maldives.

The Master Trainers who were trained by the UK team in turn conducted 4 more workshops in Colombo, Kandy, Galle and Polonnaruwa in June and July 2016.

Three more workshops will be conducted in Jaffna, Batticaloa and in Ratnapura by the master trainers over the next 3 months.

Over the past 3 years, overseas and national teams have jointly trained 626 doctors and nurses on 13 occasions all over the country.

A national neonatal transport service has now been established and is gradually being roll out to cover the whole country with a national training faculty to ensure future sustainability. This could become a major determinant in bringing down the Neonatal Mortality Rate in Sri Lanka.