Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria

Okonkwo, Ikechukwu Richard; Abhulimhen-Iyoha, Blessing Imuetinyan; Okolo, Angela A.

doi:10.11648/j.ajp.20200603.39

Cited by 6 publications

(13 citation statements)

References 15 publications

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“…Although majority of preterm admissions in our study were inborn infants, there was greater mortality (38.1%) among the out-born preterm admissions compared with inborn admissions (26.2%). The majority of these infants are usually transported to the hospital in suboptimal conditions, 17,18 and are often hypothermic and in respiratory distress on arrival. They have also been exposed to conditions that increase the risk of sepsis, such as inappropriate cord care.…”

Section: Discussionmentioning

confidence: 99%

Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria

Fajolu

Satrom

Ezenwa

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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Neonatal mortality is a major contributor to under-five mortality, and Nigeria has the second-highest number of neonatal deaths globally. The country has introduced evidence-based interventions to improve newborn care over the years. The aim of this study was to determine the current trends in neonatal morbidity and mortality at the Lagos University Teaching Hospital, monitor progress over time, and identify areas for improvement. The admission registers and case files of all the neonatal ward admissions were reviewed from January 2018 to April 2020; the age at admission, gestational age, sex, inborn or out-born status, diagnosis, and outcome were recorded and analyzed. Of the 2,959 admissions during the study period, 68.4% were out-born and 77.9% were term gestation infants. The most common diagnoses were neonatal jaundice (NNJ; 28.4%), infection (28.0%), prematurity with associated complications (22.1%), and hypoxic ischemic encephalopathy (HIE; 18.2%). The overall mortality rate was 17.6%. Prematurity with associated complications (39.2%), HIE (24.8%), congenital anomalies (CAs; 12.7%), and NNJ (11.5%) were the most common conditions associated with mortality. Of those who died, the most common diagnoses were term infants with HIE (40.7%), CAs (21.8%), NNJ (18.9%), and infection (15.5%); respiratory distress syndrome (52.4%), infection (31.8%), and CAs (7.8%) were the most common diagnoses in preterm infants. The high risk of mortality with HIE, jaundice, infections, and CAs in this cohort reflects the national figures and trends. Efforts to improve neonatal care, especially respiratory support and education of the populace on NNJ, should be intensified to reduce neonatal mortality in the country.

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Section: Discussionmentioning

confidence: 99%

Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria

Fajolu

Satrom

Ezenwa

et al. 2022

The American Journal of Tropical Medicine and Hygiene

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“…Nine studies reported on hypothermia in transported neonates albeit having differing definitions of hypothermia. Dicko et al reported that 99% of the study population had a temperature of <37°C, 41 with the other studies reporting abnormal temperatures in 20%–67% of transported neonates 12,29,35,37–39 …”

Section: Resultsmentioning

confidence: 87%

“…Eleven studies reported on the outcome of newborns transported into tertiary neonatal units for continued care with consistently high mortality in outborn transported neonates. Only 1 out of these 11 studies reported mortalities of <10%, 35 8 studies between 20% and 32% 12,28,30,34,37–39,41 . In one study the mortality was 46.8%, 40 with the highest mortality being 63.5% 29 .…”

Section: Resultsmentioning

confidence: 97%

“…Only 1 out of these 11 studies reported mortalities of <10%, 35 8 studies between 20% and 32%. 12,28,30,34,[37][38][39]41 In one study the mortality was 46.8%, 40 with the highest mortality being 63.5%. 29 Two studies with high mortalities reported significantly increased mortalities of 44% and 51.7% in the first 48 h after delivery and transfer 29,37 (Table 3).…”

Section: Neonatal Care and Access Within Health Facilitiesmentioning

confidence: 99%

“…Many newborn deaths are a consequence of a lack of contact with the health system or a lack of transfer systems to access higher‐level facilities. 10 , 11 , 12 Unfortunately, in SSA, sick newborns in need of transfer to established specialized neonatal centers remain at risk of adverse outcomes because of under‐resourced peripheral delivery facilities, lack of coordinated neonatal transport service, and frequently unsafe transfer practices. Prompt attention to appropriate referral of sick newborns might therefore significantly contribute to a reduction in the high mortality occurring on the day of birth.…”

Section: Introductionmentioning

confidence: 99%

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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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Neonatal transport practices and effectiveness of the use of low-cost interventions on the morbidity and mortality of transported neonates in Sub-Saharan Africa: A systematic review protocol

Okai

Soltani

Fair

2022

Preprint

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Objectives Poor pre-transport and intra-transport care are associated with early neonatal morbidity and mortality. The objective of this study is to produce a critical overview of research on neonatal transport practices, the use of any low-cost interventions, including Kangaroo mother care (KMC) employed in neonatal transport on the outcomes of neonates transported for specialized care in Sub-Saharan Africa, through a systematic review and narrative synthesis. Study design The study design is a protocol for systematic review Methods A comprehensive literature search will be conducted using the electronic databases of CINAHL, EMBASE, MEDLINE, Web of Science, as well as Google Scholar. A manual search will be carried out of the reference lists of eligible studies for relevant papers. The search strategy will include combining three key blocks of terms, namely: 'neonates', ‘transport’ and 'Sub Saharan Africa,' using database-specific subject headings and text words. Two independent reviewers will screen and assess data quality and extraction for synthesis. Any disagreements during the data extraction and quality assessment stages will be determined by consensus with the involvement of a third reviewer. Study quality will be assessed using the Mixed-Methods Appraisal Tool (MMAT); a narrative synthesis will be undertaken to integrate and summarise findings. Subgroup analysis will be done where data is available within countries with different groups of neonates and modes of transportation. Ethics and dissemination Approval by a research ethics committee is not required for this study since the review only includes published and publicly accessible data. Findings from this review will inform research into the use of Kangaroo Mother Care (KMC) in neonatal transport in Ghana. We will publish our findings in a peer-reviewed journal as per Preferred Reporting for Systematic Review and Meta-analysis (PRISMA) 2020 Guidance Registration PROSPERO registration CRD42022352401 Background Globally, significant progress has been made in child survival since the institution of the millennium development goals (MDGs), over two decades ago to tackle the indignity of poverty. Progress in reducing newborn mortality has however lagged behind the reduction in overall deaths in children under the age of 5 years.

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Newborn Transport Practices: Influence on Newborn Survival in Benin City, Nigeria

Cited by 6 publications

References 15 publications

Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria

Current Trends in Neonatal Morbidity and Mortality: Experiences from a Tertiary Center in Lagos, Nigeria

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

Neonatal transport practices and effectiveness of the use of low-cost interventions on the morbidity and mortality of transported neonates in Sub-Saharan Africa: A systematic review protocol

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