Neonatal mortality contributors using the three delays audit: a study from Albuluk paediatrics teaching hospital in Sudan

Abstract

Background: In certain developing countries neonatal mortality rates still showed a slower decline. Many factors were attributed to neonatal mortality that varies from one country to another. This study investigated factors attributed to neonatal mortality in Sudan.Methods: Data was collected from 72 neonatal deaths records at Albuluk pediatrics' teaching hospital, and then it was analyzed using a modified three delays model to determine contributing delays.Results: 31.9% of neonatal mortality occurred on the first day after birth and 86.1% thereafter. Newborn characteristics showed that more than half of dead newborn were male and more than 80% admitted in the age of more than 2 days although there was 26% of involved newborn were preterm. About two third of deliveries were home deliveries and only 52% of the mothers were in regular antenatal care. The leading causes of death were sepsis and pneumonia in 83% followed by birth asphyxia in 11% of total neonatal mortality. Regarding the three delays audit; delay in decision making were present in 54.2% and that was due to inability of the mothers to recognize danger signs, delay in reaching the health care facility was present in 9.8% of the neonatal mortality, while delay in initiation of treatment in the healthcare facility was present in only 6.9%.Conclusions: Maternal knowledge of neonatal danger signs and decision to seek medical care is a major contributor for neonatal mortality in this study. Further efforts should be exerting to raise knowledge of the mothers about danger signs of neonatal illness.

Modifiable Factors and Delays Associated with Neonatal Deaths and Stillbirths in Jordan: Findings from Facility-Based Neonatal Death and Stillbirth Audits

“…For instance, studies conducted in Sudan, Uganda, and India to identify the modifiable factors leading to neonatal deaths based on the "three-delay" model found that both the delay in making the decision to seek care and the delay in reaching the hospital or the health facility were the main risk factors leading to neonatal mortality. 21,22,28 However, a study conducted in Tanzania found that the high number of neonatal deaths was due to the delay in receiving care (delay 3). 29 Another study conducted in Ethiopia showed that the delays caused at home (delay 1) and at the health facility (delay 3) were the major delays that contributed to the vast majority of neonatal deaths.…”

“…Strengthening the referral system for pregnant women and sick newborns, improving ambulance services, developing a triage system, and preparing services to accept and manage women in labor and/or sick newborn babies are of paramount importance for reducing avoidable deaths. 28 Furthermore, one of the modifiable factors identified by the DRCs was the lack of some health care providers' skills in advanced medical procedures such as neonatal resuscitation and mechanical ventilation. Research has shown that approximately 5 to 10% of newborn babies need support in initiating regular spontaneous respiration.…”

Barriers & facilitators to healthcare and social services among undocumented Latino(a)/Latinx immigrant clients: Perspectives from frontline service providers in Southeast Michigan

“…This conceptual framework has been widely used across settings such as Malawi, Mozambique, and Indonesia to understand and address the multiple factors that contribute to maternal mortality [23][24][25] adapted to address neonatal and child morality in India, Tanzania, Sudan, and Uganda [26][27][28][29], and to examine barriers to civil registration in Indonesia [30]. Guided by our analysis, which revealed that undocumented clients potentially encounter three phases of delay, we believe that this integrated conceptual framework could be applied post hoc to our data to organize and frame our findings, and that it can also be useful for identifying…”

Knowledge of neonatal danger signs, care seeking practice and associated factors among postpartum mothers at public health facilities in Ambo town, Central Ethiopia

“…Studies indicated that healthcare-seeking behavior of mothers was affected by their knowledge on NDSs which is important to recognize serious illnesses on the newborns. Maternal knowledge of NDSs and delays in deciding to seek-care were major contributors for neonatal mortality [15, 16]. From study done in four regions of Ethiopia only a third of women who reported neonatal illness had sought care [16].…”