European Standards of Care for Newborn Health European

European Standards of Care for Newborn Health

European Standards of Care for Newborn Health 1. About preterm birth 2. Preterm birth at global &European levels and in our country 3. How European Standards of Care for Newborn Health help to improve health outcomes 4. The European Standards of Care for Newborn Health in a nutshell 5. What can you do?

About preterm birth A baby is born preterm, when it is born before 37 weeks of pregnancy.

Consequences of preterm birth • Health and developmental risks increase the earlier the baby is born • The use of evidence-based practices has been shown to improve survival without severe morbidities for very preterm babies • Not every preterm baby in Europe receives evidence -based treatment Chang HH, Larson J, Blencowe H, Spong CY, Howson CP, Cairns-Smith S, et al. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. The Lancet. 2013 Jan; 381(9862): 223– 34. https: //www. ncbi. nlm. nih. gov/pubmed/23158883 Euro-Peristat Project. European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015. November 2018. Available at www. europeristat. com

Reducing preterm birth and its consequences is cost-effective • Economic consequences, that go beyond the direct expenses at birth: • Financial burden on healthcare insurance • Substantial financial burden on families (e. g. therapies, reduced working capacities) • The highest rate of economic returns comes from the earliest investments in children • Money spent to prevent preterm birth, birth complications and to improve the long-term health of affected children is a “Smart Investment” for the society Hodek, Jan-Marc, J-Matthias von der Schulenburg, und Thomas Mittendorf. „Measuring Economic Consequences of Preterm Birth - Methodological Recommendations for the Evaluation of Personal Burden on Children and Their Caregivers“. Health Economics Review 1, Nr. 1 (Dezember 2011): 6. https: //doi. org/10. 1186/2191 -1991 -1 -6. Karen, T. , A. Außerer, M. Krimbacher, S. Mader, und M. Keller. „ 1209 Socioeconomic Impact of Preterm Birth in Germany and Austria: A Parental Perspective“. Pediatric Research 68, Nr. S 1 (1. November 2010): 599. https: //doi. org/10. 1203/00006450 -201011001 -01209. The Heckman Equation. https: //heckmanequation. org/resource/the-heckman-curve/

Preterm birth at global level • Every year, 15 million babies are born preterm, more than 1 baby in 10 • Every year, 1 million babies die due to complications of preterm birth • Preterm birth complications are the leading cause of death in children under five years of age • In almost all countries with reliable preterm birth data, the number of preterm birth is rising • Inequalities in survival rates and health outcomes are stark • Three quarters of deaths could be saved and complications from preterm birth could be prevented with cost-effective interventions Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis Source: Chawanpaiboon et al. 2014 Chawanpaiboon S, Vogel JP, Moller A-B, Lumbiganon P, Petzold M, Hogan D, u. a. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. The Lancet Global Health. Januar 2019; 7(1): e 37– 46. https: //www. thelancet. com/journals/langlo/article/PIIS 2214 -109 X(18)30451 -0/fulltext WHO 2019: Data and statistics. https: //www. who. int/news-room/fact-sheets/detail/preterm-birth

Preterm birth in Europe • Every year, about 500 000 babies are born preterm • Every year, 40 000 families are touched by the loss of their baby by stillbirth or death • Preterm birth complications are the reason for about three quarters of all deaths in the neonatal period • Wide differences in preterm birth rates: from less than 6% to 12% • Policies and practices related to delivery of care within countries affect variations in the preterm birth rate • There are huge disparities in survival and health outcome between the European countries Editorial. Putting the family at the centre of newborn health. The Lancet Child & Adolescent Health. 2019; 3(1). https: //www. thelancet. com/journals/lanchi/article/PIIS 2352 -4642(18)30369 -9/fulltext Euro-Peristat Project. European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015. November 2018. Available at www. europeristat. com Geographical distribution of preterm births among live births in Europe Source: Euro-Peristat Project. European Perinatal Health Report. Core indicators of the health and care of pregnant women and babies in Europe in 2015. November 2018. Available at www. europeristat. com

European disparaties in organisation and provision of care for newborns Infrastructure for high-risk pregnancies Organisation of medical centres Transport systems Education of healthcare professionals Follow-up and continuing care Medical treatment Level of implementation of infant- and familycentred care Nutrition NICU design

Preterm birth in our country • Please insert your data! Please use this slide to highlight national data from your country: What is the current situation (rates, numbers) and what are the main current challenges?

The three main needs in our country • Please use this slide to insert the three most pressing needs in your country

European Standards of Care for Newborn Health to improve health outcomes • Due to the lack of standards and respective guidelines, care strongly depends on medical routines of single hospitals or healthcare professionals on duty. Some of these are not even scientifically substantiated but have become unwritten rules within clinical routines • In daily clinical practice, standards ensure access to the best possible care for as many patients as possible since they direct decision-making and reflect best scientific evidence as well as practice experience • Although the use of evidence-based practices has been shown to improve survival without severe morbidities for very preterm babies, not every preterm baby in Europe receives evidence-base treatment • Europe’s variations in health outcome among preterm and ill babies can only be overcome by providing harmonised definitions and clear regulations for infrastructures, medical processes, care procedures, and capabilities of staff, as well as quality indicators, allowing to compare and adjust the conditions of care Chang HH, Larson J, Blencowe H, Spong CY, Howson CP, Cairns-Smith S, et al. Preventing preterm births: analysis of trends and potential reductions with interventions in 39 countries with very high human development index. The Lancet. 2013 Jan; 381(9862): 223– 34. https: //www. ncbi. nlm. nih. gov/pubmed/23158883 Gissler M, Mohangoo AD, Blondel B, Chalmers J, Macfarlane A, Gaizauskiene A, et al. Perinatal health monitoring in Europe: results from the EURO-PERISTAT project. Inform Health Soc Care. 2010 Mar; 35(2): 64– 79. https: //www. ncbi. nlm. nih. gov/pubmed/20726736 Hensen P. Versorgungsqualität und Patientensicherheit. In: Hensen P, editor. Qualitätsmanagement im Gesundheitswesen: Grundlagen für Studium und Praxis. Wiesbaden: Springer Fachmedien Wiesbaden; 2016. p. 367– 99. https: //doi. org/10. 1007/978 -3 -658 -07745 -7_13

European Standards of Care for Newborn Health in a nutshell • About 100 European reference standards for key topics in neonatal health • Each core standard is based on best scientific evidence and practice experience • Additional sections introduce initial steps towards the standard and highlight how to develop further, beyond standard • The European standards serve as reference for development, implementation or update of national binding standards and guidelines • Indicators allow for verification activities and benchmarking Special features: • Initiated by patient organisation • About 220 experts from more than 30 countries are involved in the project and engage voluntarily Project website: www. newborn-health-standards. org

European Standards of Care for Newborn Health receive worldwide support Currently, more than 170 healthcare professional societies/organisations and parent organisations support the standards.

European politicians support the Standards of Care for Newborn Health • End of 2019, the European Standards of Care for Newborn Health were launched in the European Parliament in Brussels, Belgium, together with a European Call to Action for Newborn Health • European politicians support the European Standards of Care for Newborn Health and the European Call to Action for Newborn Health with the demand that European and national policy makers, hospital administrators, insurers, professional and patient associations, and industry work together to bring the standards into practice to ensure quality, equity, and dignity for the smallest

What can you do? Commit to increase newborn health outcome at European level • Recognise the challenge of preterm birth in Europe and its significant impact on mortality, long-term health consequences and the health and social inequities linked to it • Support and prioritise equitable access to high-quality care and the development and implementation of coordinated EU health and social policies as well as • Support and prioritise the development and implementation of standards or guidelines in newborn health in your country, with reference to the European Standards of Care for Newborn Health • Address the lack of comparable European data on preterm birth and support the creation and strengthening of data collection systems and data registries • Prioritise and allocate EU funding to promote coordinated European perinatal and neonatal research • Support the development of a European training programme in perinatology and neonatology in order to increase the quality and availabilty of trained healthcare professionals Use this slide only for politicians with a European connection/interest!

What can you do? Commit to increase newborn health outcome in our country • Recognise the challenge of preterm birth and its significant impact on mortality, long-term health consequences and the health and social inequities linked to it • Support and prioritise the development and implementation of a targeted national neonatal patient centred health policy, and of national standards or guidelines with the involvement of all stakeholders and referencing to the European Standards of Care for Newborn Health • Promote and support development and implementation of targeted, evidence-based preterm birth prevention programmes • Promote and support the provision of equitable access to high quality maternal and neonatal health services • Increase access to specialised and appropriate follow-up and continuing care for preterm or ill born infants • Address the lack of comprehensive epidemiological data on preterm birth and support the creation and strengthening of Please adapt this slide for national policy makers: data collection systems Either select among the given examples 3 to 5 recommendations that are most pressing in your country or add 3 to 5 own recommendations that provide a solution to the specific needs & challenges that you highlighted at the beginning of this presentation.

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