Newborn Congenital Heart Screening Training and Evaluation Program
The Yunnan Newborn Training Program has the goal of training all rural Yunnan county obstetricians and obstetric nurses to perform proper newborn cardiac examinations. The program, started in 2014, is the largest of its kind in China and one of the largest of its kind in the world. More than sixty percent of births in rural Yunnan province occur in relatively large county hospitals. This centralization of birthing is the result of a Chinese government campaign to decrease morbidity and mortality during childbirth. County hospital newborn care protocols include testing for metabolic diseases and examination for spinal deformities but do not include routine testing using stethoscope and pulse oximetry for critical congenital heart disease, which is now routine in the United States and in most other developed nations. The training program and its evaluation have been successful in completing training in about three quarters of Yunnan county hospitals. Screening rates in almost all hospitals exceed 90%. The program has therefore been overwhelmingly successful. However, there are some important problems detected by the evaluation of the program, which are explained in this report. |