Death audit in the neonatal ICU of a tertiary care hospital in Bangladesh: a retrospective chart review

Dey, Sanjoy; Afroze, Sharmin; Islam, Tariqul; Jahan, Ismat; Shabuj, Mohammad Kamrul Hassan; Begum, Suraiya; Chisti, Mohammod Jobayer; Shahidullah, Mohammod

doi:10.1080/14767058.2017.1391779

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…Each care parameter received by women during the perinatal period was assigned a score of 1 if it was received at least once during the entire period while a score of 0 if it was not received at all during the entire period. Antenatal contacts were categorized into less than four and four or more contacts as used in previous studies of pregnancy outcome to allow generalizability and comparison of results, although the current guidelines recommend eight contacts to be sufficient contact [17,23,24].…”

Section: Data Management and Statistical Analysismentioning

confidence: 99%

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Muwema,

Nankabirwa,

Edwards

et al. 2024

BMC Pregnancy Childbirth

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Background Provision of effective care to all women and newborns during the perinatal period is a viable strategy for achieving the Sustainable Development Goal 3 targets on reducing maternal and neonatal mortality. This study examined perinatal care (antenatal, intrapartum, postpartum) and its association with perinatal deaths at three district hospitals in Bunyoro region, Uganda. Methods A cross-sectional study was conducted in which a questionnaire was administered consecutively to 872 postpartum women before discharge who had attended antenatal care and given birth in the study hospitals. Data on care received during antenatal, labour, delivery, and postpartum period, and perinatal outcome were extracted from medical records of the enrolled postnatal women using a pre-tested structured tool. The care received from antenatal to 24 h postpartum period was assessed against the standard protocol of care established by World Health Organization (WHO). Poisson regression was used to assess the association between care received and perinatal death. Results The mean age of the women was 25 years (standard deviation [SD] 5.95). Few women had their blood tested for hemoglobin levels, HIV, and Syphilis (n = 53, 6.1%); had their urine tested for glucose and proteins (n = 27, 3.1%); undertook an ultrasound scan (n = 262, 30%); and had their maternal status assessed (n = 122, 14%) during antenatal care as well as had their uterus assessed for contraction and bleeding during postpartum care (n = 63, 7.2%). There were 19 perinatal deaths, giving a perinatal mortality rate of 22/1,000 births (95% Confidence interval [CI] 8.1–35.5). Of these 9 (47.4%) were stillbirths while the remaining 10 (52.6%) were early neonatal deaths. In the antenatal phase, only fetal examination was significantly associated with perinatal death (adjusted prevalence ratio [aPR] = 0.22, 95% CI 0.1–0.6). No significant association was found between perinatal deaths and care during labour, delivery, and the early postpartum period. Conclusion Women did not receive all the required perinatal care during the perinatal period. Perinatal mortality rate in Bunyoro region remains high, although it’s lower than the national average. The study shows a reduction in the proportion of perinatal deaths for pregnancies where the mother received fetal monitoring. Strategies focused on strengthened fetal status monitoring such as fetal movement counting methods and fetal heart rate monitoring devices during pregnancy need to be devised to reduce the incidence of perinatal deaths. Findings from the study provide valuable information that would support the strengthening of perinatal care services for improved perinatal outcomes.

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Section: Data Management and Statistical Analysismentioning

confidence: 99%

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Muwema,

Nankabirwa,

Edwards

et al. 2024

BMC Pregnancy Childbirth

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“… 1 In low-income and middle-income countries (LMICs), although 85% of pregnant women receive at least one ANC visit with a skilled provider, only 58% receive at least four visits. 2–4 In Mali, these figures were 80% and 43%, respectively, in 2018. 5 Reasons for poor coverage of ANC include financial barriers (formal and informal fees for service), geographical barriers and inadequate staff to provide high-quality, respectful care.…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Effect of community health worker home visits on antenatal care and institutional delivery: an analysis of secondary outcomes from a cluster randomised trial in Mali

et al. 2023

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IntroductionThough community health workers (CHWs) have improved access to antenatal care (ANC) and institutional delivery in different settings, it is unclear what package and delivery strategy maximises impact.MethodsThis study reports a secondary aim of the Proactive Community Case Management cluster randomised trial, conducted between December 2016 and April 2020 in Mali. It evaluated whether proactive home visits can improve ANC access at a population level compared with passive site-based care. 137 unique village clusters, covering the entire study area, were stratified by health catchment area and distance to the nearest primary health centre. Within each stratum, clusters were randomly assigned to intervention or control arm. CHWs in intervention clusters proactively visited all homes to provide care. In the control clusters, CHWs provided the same services at their fixed community health post to care-seeking patients. Pregnant women 15–49 years old were enrolled in a series of community-based and facility-based visits. We analysed individual-level annual survey data from baseline and 24-month and 36-month follow-up for the secondary outcomes of ANC and institutional delivery, complemented with CHW monitoring data during the trial period. We compared outcomes between: (1) the intervention and control arms, and (2) the intervention period and baseline.ResultsWith 2576 and 2536 pregnancies from 66 and 65 clusters in the intervention and control arms, respectively, the estimated risk ratios for receiving any ANC was 1.05 (95% CI 1.02 to 1.07), four or more ANC visits was 1.25 (95% CI 1.08 to 1.43) and ANC initiated in the first trimester was 1.11 (95% CI 1.02 to 1.19), relative to the controls; no differences in institutional delivery were found. However, both arms achieved large improvements in institutional delivery, compared with baseline. Monitoring data show that 19% and 2% of registered pregnancies received at least eight ANC contacts in the intervention and control arms, respectively. Six clusters, three from each arm had to be dropped in the last 2 years of the trial.ConclusionsProactive home visits increased ANC and the number of antenatal contacts at the clinic and community levels. ANC and institutional delivery can be increased when provided without fees from professional CHWs in upgraded primary care clinics.Trial registration numberNCT02694055.

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Antenatal Care Visit Attendance Frequency and Birth Outcomes in Rural Uganda: A Prospective Cohort Study

Boatin

Mugyenyi

Siedner

et al. 2020

Matern Child Health J

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Death audit in the neonatal ICU of a tertiary care hospital in Bangladesh: a retrospective chart review

Abstract: In conclusion, less than four antenatal visits and presence of sepsis were found to be independent risk factors whereas LUCS protective of newborn death.

Cited by 4 publications

References 12 publications

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Perinatal care and its association with perinatal death among women attending care in three district hospitals of western Uganda

Effect of community health worker home visits on antenatal care and institutional delivery: an analysis of secondary outcomes from a cluster randomised trial in Mali

Antenatal Care Visit Attendance Frequency and Birth Outcomes in Rural Uganda: A Prospective Cohort Study

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