TY - JOUR T1 - Small and sick newborn care during the COVID-19 pandemic: global survey and thematic analysis of healthcare providers’ voices and experiences JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-004347 VL - 6 IS - 3 SP - e004347 AU - Suman P N Rao AU - Nicole Minckas AU - Melissa M Medvedev AU - David Gathara AU - Prashantha Y N AU - Abiy Seifu Estifanos AU - Alfrida Camelia Silitonga AU - Arun Singh Jadaun AU - Ebunoluwa A Adejuyigbe AU - Helen Brotherton AU - Sugandha Arya AU - Rani Gera AU - Chinyere V Ezeaka AU - Abdou Gai AU - Abebe Gebremariam Gobezayehu AU - Queen Dube AU - Aarti Kumar AU - Helga Naburi AU - Msandeni Chiume AU - Victor Tumukunde AU - Araya Abrha Medhanyie AU - Gyikua Plange-Rhule AU - Josephine Shabini AU - Eric O Ohuma AU - Henok Tadele AU - Fitsum W/Gebriel AU - Amanuel Hadgu AU - Lamesgin Alamineh AU - Rajesh Mehta AU - Elizabeth Molyneux AU - Joy E Lawn A2 - , Y1 - 2021/03/01 UR - http://gh.bmj.com/content/6/3/e004347.abstract N2 - Introduction The COVID-19 pandemic is disrupting health systems globally. Maternity care disruptions have been surveyed, but not those related to vulnerable small newborns. We aimed to survey reported disruptions to small and sick newborn care worldwide and undertake thematic analysis of healthcare providers’ experiences and proposed mitigation strategies.Methods Using a widely disseminated online survey in three languages, we reached out to neonatal healthcare providers. We collected data on COVID-19 preparedness, effects on health personnel and on newborn care services, including kangaroo mother care (KMC), as well as disruptors and solutions.Results We analysed 1120 responses from 62 countries, mainly low and middle-income countries (LMICs). Preparedness for COVID-19 was suboptimal in terms of guidelines and availability of personal protective equipment. One-third reported routine testing of all pregnant women, but 13% had no testing capacity at all. More than 85% of health personnel feared for their own health and 89% had increased stress. Newborn care practices were disrupted both due to reduced care-seeking and a compromised workforce. More than half reported that evidence-based interventions such as KMC were discontinued or discouraged. Separation of the mother–baby dyad was reported for both COVID-positive mothers (50%) and those with unknown status (16%). Follow-up care was disrupted primarily due to families’ fear of visiting hospitals (~73%).Conclusion Newborn care providers are stressed and there is lack clarity and guidelines regarding care of small newborns during the pandemic. There is an urgent need to protect life-saving interventions, such as KMC, threatened by the pandemic, and to be ready to recover and build back better. ER -