Scope of Neonatal Care Services in Major Nigerian Hospitals

Background: Neonatal survival bespeaks the quality of neonatal care services available and accessible to the population. Intensive care improves outcome of high-risk infants with serious illness. The tiered level of care is yet to be applied to newborn care in Nigeria. Classification of care is key to improving neonatal survival with enhanced referral of high-risk patients to higher-level centres. Objective: To ascertain the scope and classify available newborn services offered at major Nigerian hospitals.Methodology: A semi-structured validated questionnaire was administered to attendees during 2015 Pediatric Association of Nigeria conference. The information derived was used to categorize neonatal care services.Results: The respondents consisted of doctors 201 (84.8%) and nurses 36 (15.2%) in 54 health facilities from all geopolitical regions of Nigeria. Of the 54 facilities; 34 (63%) were located in state capitals and 47 (87%) in public hospitals. Half of the evaluated units belonged to Class I; 22 (40.7%) Class II; and 5 (9.3%) Class III levels of neonatal care. Majority (81.6%) of the doctors have been trained on neonatal resuscitation; with senior residents being the highest 49 (89%) and Medical officers (MO) the least 4 (40%) trained. Doctors with training in mechanical ventilation (MV) were 39.2%; Consultants (51.2%); MO's the least 1(11.2%) trained (p=0.025). Monitoring is usually by pulse oximeters 54 (100%); multi parameter monitors 23 (42.6%) and rarely ABGs 6 (11%).Conclusion: Neonatal care in Nigeria is still developing. Most centres provide basic neonatal care services. Regionalization of care may be the solution to higher level neonatal care

Socioeconomic and cultural factors associated with mortality in Malaria induced anaemia among under-five children in Benin city, Nigeria.

Background: Children under the age of five years bear the brunt of malaria infection. Malaria induced anaemia (MIA) is the most prevalent presentation of malaria and a major cause of morbidity and mortality in Nigeria. Objective: To determine the socioeconomic and cultural factors associated with mortality in under-five children presenting with malaria induced anaemia. Methods: This is a cross-sectional descriptive study conducted at the Children Emergency Room of the University of Benin Teaching Hospital, Benin City, Nigeria. Questionnaires which were researcher-administered were used to collect information on the child’s age, gender, parents’ or caregiver’s education, occupation, recognition of symptoms of malaria and anaemia, cultural practices during child’s illness and patients’ outcome. Results: The case fatality rate was 3.1%. Poor parental education, low social class and lack of skilled job amongst the parents were associated with high mortality. Other factors associated with mortality include high patronage of chemists and prayer houses as well as poor recognition of pallor by mothers. Conclusion/Recommendations: Improvement in socioeconomic status especially female education and empowerment is again emphasized. This and other socioeconomic boost should be targeted alongside malaria-control programmes in order to reduce mortality associated with malaria induced anaemia. Parental enlightenment on recognition of symptoms of malaria and anaemia will improve their health-seeking behaviour, promote early diagnosis and prompt institution of effective antimalarial therapy.