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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.


Mortality rate indices. NNMR: neonatal mortality rate; NNMRexcl.d48: neonatal mortality rate without neonates that die within 48 hours of presentation; average was based on the outreach centres.
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fig9: Mortality rate indices. NNMR: neonatal mortality rate; NNMRexcl.d48: neonatal mortality rate without neonates that die within 48 hours of presentation; average was based on the outreach centres.

Mentions: Only 5 of 15 invited centres submitted their data for inclusion in the present analysis. These were from tertiary hospitals located in the southern Nigeria (C1 and C2), middle-belt (C3), and north (C4). We received submission from only one classified “control” centre (CC), a tertiary hospital in southern Nigeria (Figure 9). Average neonatal mortality (NNMR) across the outreach centres was computed at 114 deaths per 1000 neonatal admissions (114/1000). When d48 mortality was excluded, average NNMR reduced to 65/1000. Death rates were twice higher than these at the control centre (Figure 9).


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)

Mortality rate indices. NNMR: neonatal mortality rate; NNMRexcl.d48: neonatal mortality rate without neonates that die within 48 hours of presentation; average was based on the outreach centres.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig9: Mortality rate indices. NNMR: neonatal mortality rate; NNMRexcl.d48: neonatal mortality rate without neonates that die within 48 hours of presentation; average was based on the outreach centres.
Mentions: Only 5 of 15 invited centres submitted their data for inclusion in the present analysis. These were from tertiary hospitals located in the southern Nigeria (C1 and C2), middle-belt (C3), and north (C4). We received submission from only one classified “control” centre (CC), a tertiary hospital in southern Nigeria (Figure 9). Average neonatal mortality (NNMR) across the outreach centres was computed at 114 deaths per 1000 neonatal admissions (114/1000). When d48 mortality was excluded, average NNMR reduced to 65/1000. Death rates were twice higher than these at the control centre (Figure 9).

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.