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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.


Neonatal mortality within 48 hours. “d48” stood for neonates that die within 48 hours of presentation, “low-para.d48” counted the size of very low parameter (≤1500 g or <33 wks) cases within the d48 baby population.
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fig10: Neonatal mortality within 48 hours. “d48” stood for neonates that die within 48 hours of presentation, “low-para.d48” counted the size of very low parameter (≤1500 g or <33 wks) cases within the d48 baby population.

Mentions: Typically, we computed that up to 64% of overall deaths of incubator-dependent-neonates (IDN) at the respective centres occurred within 48 hours of presentation. There were very few survivals amongst babies born before 30 weeks gestation or below a birth weight of 1000 g. Data also revealed that nearly all of the babies dying within the 48 hour window were either “born very early” or “born very small” (Figure 10). Average length of surviving IDN hospitalisation at the outreach centres was 20.5 days (average centre range: 8–32 days). This was not quantified at the “control” as supplied data lacked such details.


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)

Neonatal mortality within 48 hours. “d48” stood for neonates that die within 48 hours of presentation, “low-para.d48” counted the size of very low parameter (≤1500 g or <33 wks) cases within the d48 baby population.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig10: Neonatal mortality within 48 hours. “d48” stood for neonates that die within 48 hours of presentation, “low-para.d48” counted the size of very low parameter (≤1500 g or <33 wks) cases within the d48 baby population.
Mentions: Typically, we computed that up to 64% of overall deaths of incubator-dependent-neonates (IDN) at the respective centres occurred within 48 hours of presentation. There were very few survivals amongst babies born before 30 weeks gestation or below a birth weight of 1000 g. Data also revealed that nearly all of the babies dying within the 48 hour window were either “born very early” or “born very small” (Figure 10). Average length of surviving IDN hospitalisation at the outreach centres was 20.5 days (average centre range: 8–32 days). This was not quantified at the “control” as supplied data lacked such details.

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.