An analysis of inter-healthcare facility transfer of neonates within the eThekwini Health District of KwaZulu-Natal, South Africa

Ashokcoomar, Pradeep

doi:10.7196/samj.2016.v106i5.8554

Cited by 18 publications

(37 citation statements)

References 7 publications

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“…It is lower than the ambulance transfers done in 71.3% of neonates who died and 68.2% of those who survived in another Bangladeshi study [31]. It also seems lower than a South African study which described 120 road ambulance transfers occurring in one district over a year and an Indian study which reported that ambulance transfers formed 75% of inter-facility transfers [44,45]. Our findings may be a reflection of the low level of resources available in this region.…”

Section: Discussioncontrasting

confidence: 56%

“…Our findings may be a reflection of the low level of resources available in this region. Travelling by ambulance usually provides a source of oxygen, equipment for resuscitating newborns, drugs and other supplies to stabilise the infant during travel [28,33,44].…”

Section: Discussionmentioning

confidence: 99%

“…Even when the transport infrastructure is ideal, it is important that neonates are accompanied by trained health professionals carrying additional equipment or drugs to deal with any untoward events that may occur on the way [20,28,32,33,44]. These professionals also support the caregiver and provide additional information to the destination hospitals when necessary.…”

Section: Discussionmentioning

confidence: 99%

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The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

et al. 2020

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Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

et al. 2020

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“…[9][10][11] It is essential to remember that CCR is still in its infancy in South Africa, and many questions remain as to the best approach to these retrievals and transports, both locally and internationally. 2,3 However, it is our firm belief that standard-setting is an essential first step. 4 For this reason, our proposed definition outlines five equally important aspects (Figure 1) that should be demonstrable and interlinked to be denoted a CCRS.…”

Section: The Definition Development Pro-cessmentioning

confidence: 99%

“…Currently, these transfers are largely undertaken by advanced life support (ALS) prehospital practitioners without additional postgraduate training. 2,3 The need for additional training and standard-setting for prehospital healthcare practitioners who undertake these transfers has previously been described by the Critical Care Retrieval Working Group (CCRWG). 4 One of the first steps in standard-setting is to draw a clear distinction between the transfer of a patient from one facility to another, and the transfer of a highly dependent, critical care patient, as this will allow for appropriate resource allocation.…”

Section: Introductionmentioning

confidence: 99%

A proposed definition of Critical Care Retrieval in the South African context

Venter

Conradie

Venter³

et al. 2021

SAJPEC

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Background: Critical care retrieval is a nascent field in South Africa. An increasing number of private and provincial emergency medical services are starting to invest in developing and setting up dedicated critical care retrieval services (CCRS). To date, there are no minimum standards or definitions on what constitutes a CCRS in the South African context. The aim of this paper is to describe the development of and propose a consensus definition of CCRS within the South African context. Methods: A literature search was performed to determine the key aspects of CCRS definitions elsewhere. An initial draft definition was circulated to the CCRS working group of the Emergency Care Society of South Africa (ECSSA) for commentary. Comments were collated, and a second round of commentary was undertaken. Finally, a consensus meeting was held through video-conferencing to finalise the definition presented herein. Thereafter, the definition was circulated to key role-players in emergency and critical care, both locally and internationally, for endorsement. The definition, as it is presented, has been endorsed by the ECSSA, the Southern African Society of Critical Care (SASCC), and the International Board for Specialty Certification (IBSC). Results: The proposed definition outlines five equally important aspects that should be demonstrable and interlinked to be denoted a CCRS. These five aspects are: specific patient populations, case selection, dedicated crew with additional training, dedicated equipment, and continuous quality management and training. Conclusion: Numerous questions remain unanswered regarding the best approach for CCRS development in South Africa and internationally. Defining what CCRS is in a South African context is a necessary departure point for further research endeavours to develop a core curriculum and practice standards.

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Neonatal transport practices and effectiveness of the use of low‐cost interventions on outcomes of transported neonates in Sub‐Saharan Africa: A systematic review and narrative synthesis

Okai,

Fair,

Soltani

2024

Health Science Reports

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Background and AimsNeonatal deaths contribute significantly to under‐5 mortality worldwide with Sub‐Saharan Africa (SSA) alone accounting for 43% of global newborn deaths. Significant challenges in the region's health systems evidenced by huge disparities in health facility deliveries and poor planning for preterm births are major contributors to the high neonatal mortality. Many neonates in the region are delivered in suboptimal conditions and require transportation to facilities equipped for specialized care. This review describes neonatal transport across the subregion, focusing on low‐cost interventions employed.MethodsWe conducted a systematic review of studies on neonatal transport in SSA followed by a narrative synthesis. A search in the databases CINAHL, EMBASE, MEDLINE, Web of Science, African Index Medicus, and Google Scholar was performed from inception to March 2023. Two authors reviewed the full texts of relevant studies to determine eligibility for inclusion which was subsequently cross‐checked by a third reviewer using a random 30% overlay. The quality of the included studies was assessed using the Mixed Methods Appraisal Tool.ResultsA total of 20 studies were included in this review involving 11,895 neonates from 10 countries. All studies evaluated the transfer of neonates into referral centers from the peripheries. Most neonates were transferred by public transport (n = 12), mostly in the arms of caregivers with little communication between referring facilities. Studies reporting on ambulance transfers reported pervasive inadequacies in both human resources and transport equipment. No study reported on the use of Kangaroo mother care (KMC) in the transfer process.ConclusionsThe neonatal transport system across the SSA region is poorly planned, poorly resourced, and executed with little communication between facilities. Using cost‐effective measures like KMC and improved training of community health workers may be key to improving the outcomes of transported neonates.

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An analysis of inter-healthcare facility transfer of neonates within the eThekwini Health District of KwaZulu-Natal, South Africa

Cited by 18 publications

References 7 publications

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

A proposed definition of Critical Care Retrieval in the South African context

Neonatal transport practices and effectiveness of the use of low‐cost interventions on outcomes of transported neonates in Sub‐Saharan Africa: A systematic review and narrative synthesis

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