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Challenges and frugal remedies for lowering facility based neonatal mortality and morbidity: a comparative study.

Amadi HO, Osibogun AO, Eyinade O, Kawuwa MB, Uwakwem AC, Ibekwe MU, Alabi P, Ezeaka C, Eleshin DG, Ibadin MO - Int J Pediatr (2014)

Bottom Line: Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000.It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters.The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.

View Article: PubMed Central - PubMed

Affiliation: Department of Bioengineering, Imperial College London, South Kensington Campus, SW7 2AZ, UK.

ABSTRACT
Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one "control" were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.

No MeSH data available.


Incubator capacity growth or dwindle timeline. (a) Hospitals with little failure-preventive audit culture (FAC) disruption. (b) Hospitals with lengthy FAC disruption. Y-axis represented the total number of functional incubators. Neonatal centres were located at various Nigerian cities: FMCow (city of Owerri), LUTH (Idi-Araba Lagos), FMCng (Nguru), UBTH (Benin-city), UNTH (Enugu), UITH (Ilorin), UPTH (Port Harcourt), and JUTH (Jos).
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fig8: Incubator capacity growth or dwindle timeline. (a) Hospitals with little failure-preventive audit culture (FAC) disruption. (b) Hospitals with lengthy FAC disruption. Y-axis represented the total number of functional incubators. Neonatal centres were located at various Nigerian cities: FMCow (city of Owerri), LUTH (Idi-Araba Lagos), FMCng (Nguru), UBTH (Benin-city), UNTH (Enugu), UITH (Ilorin), UPTH (Port Harcourt), and JUTH (Jos).

Mentions: A good number of the hospitals signed the agreements and operated the failure-preventive audit culture (FAC) component of the outreach (Figure 7). The managements of few hospitals ensured unbroken FAC services, some lasting up to 8 years to the time of this report. FAC was broken a number of times in other hospitals due to administrative successions that never considered this very important but restarted after it became obvious that stoppage had resulted in many SCBU disasters. We found that centres with less unbroken FAC operated with more consistent or increasing incubator capacities (Figures 7 and 8).


Challenges and frugal remedies for lowering facility based neonatal mortality and morbidity: a comparative study.

Amadi HO, Osibogun AO, Eyinade O, Kawuwa MB, Uwakwem AC, Ibekwe MU, Alabi P, Ezeaka C, Eleshin DG, Ibadin MO - Int J Pediatr (2014)

Incubator capacity growth or dwindle timeline. (a) Hospitals with little failure-preventive audit culture (FAC) disruption. (b) Hospitals with lengthy FAC disruption. Y-axis represented the total number of functional incubators. Neonatal centres were located at various Nigerian cities: FMCow (city of Owerri), LUTH (Idi-Araba Lagos), FMCng (Nguru), UBTH (Benin-city), UNTH (Enugu), UITH (Ilorin), UPTH (Port Harcourt), and JUTH (Jos).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4129921&req=5

fig8: Incubator capacity growth or dwindle timeline. (a) Hospitals with little failure-preventive audit culture (FAC) disruption. (b) Hospitals with lengthy FAC disruption. Y-axis represented the total number of functional incubators. Neonatal centres were located at various Nigerian cities: FMCow (city of Owerri), LUTH (Idi-Araba Lagos), FMCng (Nguru), UBTH (Benin-city), UNTH (Enugu), UITH (Ilorin), UPTH (Port Harcourt), and JUTH (Jos).
Mentions: A good number of the hospitals signed the agreements and operated the failure-preventive audit culture (FAC) component of the outreach (Figure 7). The managements of few hospitals ensured unbroken FAC services, some lasting up to 8 years to the time of this report. FAC was broken a number of times in other hospitals due to administrative successions that never considered this very important but restarted after it became obvious that stoppage had resulted in many SCBU disasters. We found that centres with less unbroken FAC operated with more consistent or increasing incubator capacities (Figures 7 and 8).

Bottom Line: Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000.It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters.The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.

View Article: PubMed Central - PubMed

Affiliation: Department of Bioengineering, Imperial College London, South Kensington Campus, SW7 2AZ, UK.

ABSTRACT
Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one "control" were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.

No MeSH data available.