Parental costs for in-patient neonatal services for perinatal asphyxia and low birth weight in Ghana

Enweronu‐Laryea, Christabel; Andoh, Hilary D.; Frimpong-Barfi, Audrey; Asenso-Boadi, Francis

doi:10.1371/journal.pone.0204410

Cited by 40 publications

(37 citation statements)

References 21 publications

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“…Survivors often face lifelong health problems (80%), such as disabilities, developmental delays, palsy, intellectual disabilities, and behavioural problems [7–10]. Furthermore, birth asphyxia places financial and emotional burdens on the families and communities involved [10, 11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study

Abdo¹,

Halil²,

Kebede³

et al. 2019

BMC Pregnancy Childbirth

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BackgroundBirth asphyxia is a major contributor to neonatal mortality worldwide. In Ethiopia, birth asphyxia remains a severe condition that leads to significant mortality and morbidity. This study aims to assess the prevalence and contributing factors of birth asphyxia among the neonates delivered at the Nigist Eleni Mohammed Memorial Teaching Hospital, Southern Ethiopia.MethodsThis hospital-based cross-sectional study was carried out on 279 participants using the systematic sampling method during June 1–30, 2019. Data were collected using a pretested structured interviewer administered questionnaire, check list and chart review, which was used to retrieve medical information and mother’s test results that could not be captured by the interview. Data were entered into EpiData (version 3.1) and analyzed using SPSS software (version 24). Multivariable regression analysis was used to identify the association between the independent variables and outcome variable with a 95% confidence interval (CI).ResultThe overall prevalence of birth asphyxia among newborns was found to be 15.1%. Factors that were significantly associated with birth asphyxia included mothers aged ≥35 (AOR = 6.4; 95% CI = 2.0–20.5), primigravida (AOR = 5.1; 95% CI =2.0–13.3), prolonged second stage of labor (AOR = 4.6; 95%CI =1.6–13.3), preterm birth (AOR = 4.7; 95% CI =1.5–14.1), meconium stained amniotic fluid (AOR = 7.5; 95% CI =2.5–21.4) and tight nuchal (AOR = 3.1; 95% CI =1.2–9.3).ConclusionBirth asphyxia is still prevalent in the study setting. The obtained findings indicated that the mothers aged ≥35, being primigravida, preterm birth, meconium stained amniotic fluid and tight nuchal were the factors associated with birth asphyxia. The results of this study show the need for better maternal care, creating awareness about contributing factors of birth asphyxia to the maternity health professionals, careful monitoring of labor, and identifying and taking proper measures that could help in reducing the occurrence of birth asphyxia.

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Section: Introductionmentioning

confidence: 99%

Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study

Abdo¹,

Halil²,

Kebede³

et al. 2019

BMC Pregnancy Childbirth

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“…Previous studies of the experiences of LBW and preterm babies have mostly focused on HIV-uninfected mothers' experiences, particularly in the NICU [10,33,35]. They show that mothers of LBW babies experience short and long-term mental health difficulties [13,14,35,57], including depression [58,59], trauma [60] and stress from the economic burden of LBW infant care [46]. We found that HIV stigma, especially experienced immediately after diagnosis, also played a role.…”

Section: Discussionmentioning

confidence: 74%

“…In one study in Ghana, about 75% of mothers with LBW, preterm, and sick infants reported mild to severe symptoms of postpartum depression [13]. Families of LBW/preterm babies in Ghana spend about 8% of their annual income on their care [14]. Caring for a LBW infant in Ghana affects maternal postpartum HIV care practices, including adherence to antiretroviral therapy and retention in clinical care [15].…”

Section: Introductionmentioning

confidence: 99%

Stigma toward small babies and their mothers in Ghana: A study of the experiences of postpartum women living with HIV

et al. 2020

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Infants born to HIV-infected mothers are more likely to be low birthweight (LBW) than other infants, a condition that is stigmatized in many settings worldwide, including sub-Saharan Africa. Few studies have characterized the social-cultural context and response to LBW stigma among mothers in sub-Saharan Africa or explored the views of women living with HIV (WLHIV) on the causes of LBW. We purposively sampled thirty postpartum WLHIV, who had given birth to either LBW or normal birthweight infants, from two tertiary hospitals in Accra, Ghana. Using semi-structured interviews, we explored women's understanding of the etiology of LBW, and their experiences of caring for a LBW infant. Interviews were analyzed using interpretive phenomenology. Mothers assessed their babies' smallness based on the baby's size, not hospital-recorded birthweight. Several participants explained that severe depression and a loss of appetite, linked to stigma following an HIV diagnosis during pregnancy, contributed to infants being born LBW. Women with small babies also experienced stigma due to the newborns' "undesirable" physical features and other people's unfamiliarity with their size. Consequently, mothers experienced blame, reluctance showing the baby to others, and social gossip. As a result of this stigma, women reported self-isolation and depressive symptoms. These experiences were layered on the burden of healthcare and infant feeding costs for LBW infants. LBW stigma appeared to attenuate with increased infant weight gain. A few of the women also did not breastfeed because they thought their baby's small size indicated pediatric HIV infection. Among WLHIV in urban areas in Ghana, mother and LBW infants may experience LBW-related stigma. A multi-component intervention that includes reducing LBW incidence, treating antenatal depression, providing psychosocial support after a LBW birth, and increasing LBW infants' weight gain are critically needed.

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“…A review of the literature showed limited published economic evaluation specific for inpatient neonatal services in Ghana. 14 This study sought to determine the best estimate of actual cost of neonatal services for babies with perinatal asphyxia and LBW/preterm at a district and regional hospital by using a micro-costing approach that examined the process of care. The economic cost of hospital-based neonatal services on families has been described elsewhere.…”

Section: Introductionmentioning

confidence: 99%

Evaluating services for perinatal asphyxia and low birth weight at two hospitals in Ghana: a micro-costing analysis

Enweronu‐Laryea

Nsiah-Boateng

Andoh

et al. 2020

Ghana Medical Journal

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Background: Neonatal mortality has been decreasing slowly in Ghana despite investments in maternal-newborn services. Although community-based interventions are effective in reducing newborn deaths, hospital-based services provide better health outcomes. Objective: To examine the process and cost of hospital-based services for perinatal asphyxia and low birth weight/preterm at a district and a regional level referral hospital in Ghana. Methods: A cross-sectional study was conducted at 2 hospitals in Greater Accra Region during May-July 2016. Term infants with perinatal asphyxia and low birth weight/preterm infants referred for special care within 24hours after birth were eligible. Time-driven activity-based costing (TDABC) approach was used to examine the process and cost of all activities in the full cycle of care from admission until discharge or death. Costs were analysed from health provider's perspective. Results: Sixty-two newborns (perinatal asphyxia 27, low-birth-weight/preterm 35) were enrolled. Cost of care was proportionately related to length-of-stay. Personnel costs constituted over 95% of direct costs, and all resources including personnel, equipment and supplies were overstretched. Conclusion: TDABC analysis revealed gaps in the organization, process and financing of neonatal services that undermined the quality of care for hospitalized newborns. The study provides baseline cost data for future cost-effectiveness studies on neonatal services in Ghana.

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Parental costs for in-patient neonatal services for perinatal asphyxia and low birth weight in Ghana

Cited by 40 publications

References 21 publications

Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study

Prevalence and contributing factors of birth asphyxia among the neonates delivered at Nigist Eleni Mohammed memorial teaching hospital, Southern Ethiopia: a cross-sectional study

Stigma toward small babies and their mothers in Ghana: A study of the experiences of postpartum women living with HIV

Evaluating services for perinatal asphyxia and low birth weight at two hospitals in Ghana: a micro-costing analysis

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