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Abstract

Strategies to introduce in the clinical practice the delayed clamping of the umbilical cord to diminish child anemia (PDF) 
Presentation at the 12th World Congress on Public Health, Istanbul, 29 April
Gonzales Salguero,Fernando
Publication date: 2009


Child nutritional anemia in Bolivia is a public health problem. According to 2003 DHS data, 88 percent of children between 6 and 23 months had some degree of anemia; five years later, a study carried out by the Ministry of Health (2007), showed that prevalence had not changed (89%).From 2003 to 2007, the Ministry of Health implemented nutritional programs for iron supplementation, without results. The absence of a response is due to cultural and logistical factors that limit regular consumption of these supplements.Delayed clamping of the umbilical cord is an evidence-based intervention that can prevent the emergence of child anemia as it provides an additional two months of essential iron reserves for the first year of life.Between May and August 2008, the Management and Quality in Health Project, implemented by John Snow, Inc., used two different strategies to incorporate the delayed clamping of the umbilical cord in the practice of health providers at three hospitals in Bolivia, one of them was a two-day workshop and the other the workshop followed by one month of peer supervision. Results from the observation of more than 1,000 vaginal deliveries showed significant increase in the number of deliveries in which delayed clamping was practiced (from 1% to 71%). The most effective strategy was that which incorporated peer supervision (94% more than workshop only).The expansion of this experience can contribute to a decrease in child anemia and should be introduced in "service delivery guidelines" and health providers' practice, especially in countries where nutritional anemia has a high prevalence.

Learning objective
To share the feasibility of introducing delayed clamping of the umbilical cord as an evidence-based intervention to prevent child anemia in contexts where it has high prevalence. To identify different strategies to introduce at the service level delayed clamping of the umbilical cord to prevent child anemia in areas with high anemia prevalence.