Ministry of Health – Main activities to promote improved treatment for premature babies, in honor of World Prematurity Day 2014

Prematurity is defined as delivery prior to week 37 of pregnancy. In 2013, 12,516 premature babies were born, constituting 7.32% of the 171,088 births in Israel that year. 1.237% of babies were born before week 33, and 0.3% are born before week 28.  Approximately one third of all premature babies were twins, and some 2% were triplets or higher-order births.
The Ministry of Health is working decisively to promote improved treatment for premature babies. Below are the highlights of its activities:
Public Health Services at the Ministry of Health, in conjunction with the “Ashalim” association, have developed a program to improve monitoring of premature babies in the community at Tipat Halav family health centers.  The program involves an extensive training course on the unique needs of premature babies and how to provide these needs, to be given to 30 public healthcare nurses, who will coordinate this field and be responsible for monitoring premature babies in 4 sub-districts in Israel.  
Monitoring the growth of premature babies: A circular on monitoring growth in infants and children was published by the director of Public Health Services , which adopts the standard growth charts published by the World Health Organization in 2006.  The circular devotes a special section to monitoring growth of premature infants, with instructions for assessing growth while making adjustments for the baby’s chronological age in accordance with the number of weeks that the baby was born prematurely.  An additional section on monitoring head circumference includes information about additional professional issues related to monitoring of premature infants.  The Ministry of Health continues to work to make child development services accessible at early childhood centers and at child development centers that have been opened in localities that have joined Program 360 – the National Program for Prevention and Treatment of Children and Youth at Risk.
The Ministry of Health has decided to establish a pilot milk bank. A circular has been published regarding operational procedures for milk bank management. Several hospitals have expressed interest in establishing a milk bank, and are at advanced stages of implementation of the program.  The Ministry of Health has initiated funding and support for the establishment of a milk bank at two hospitals in peripheral regions.

A neonatal ICU incentives program has been created:

  1. In December 2013, a circular published by the Medical Administration, set standards for treatment in neonatal intensive care units, based on consultations with the Neonatal Society.
  2. Allocation of beds for neonatal intensive care units – 240 of the 960 beds in the general beds program for 2011-15.
  3. The incentives model – The treasury has agreed to allocate money to improve the state of the neonatal intensive care units, using a special incentives model known as the stars model.  This incentives model assesses inputs and outcomes based on the standards recommended in the circular published by the Medical Administration  in December 2013. These include human resources, infrastructure and incidents of infection in neonatal intensive care units. The treasury has agreed to allocate an annual increase of NIS 20 million to the basic budget each year for 4 years, for a total of a NIS 80 million increase. The five most outstanding neonatal intensive care units will receive a double increase for each premature baby.
  4. A daily report of neonatal intensive care unit (NICU) occupancy rates (for all NICUs) has been distributed to all NICU directors since June 2014. This helps regulate transfer of premature babies and pregnant women who are at risk for premature birth from hospitals with overcrowded NICUs.
  5. The National “Touch Zero” Program: A program that aims to reduce the prevalence of NICU-acquired infections has been underway for several months. The program is led by the Israel Neonatal Society, in conjunction with neonatal intensive care unit nurses and the Ministry of Health.
    The objective of the program is to reduce the prevalence of NICU-acquired infections by 25% each year, through cultural and behavioral changes and by improving work practices of the staff responsible for premature babies.
    The procedure includes creating uniform guidelines for treatment of premature babies throughout Israel, use of checklists, observation, monitoring adherence to the guidelines and learning from incidents of infection.
    A local team has been appointed at each neonatal intensive care unit to implement the program. This team is directed by the project’s central steering committee, in conjunction with all neonatal intensive care units.