Factors contributing to neonatal admissions and outcomes at Effia Nkwanta regional hospital: January to December 2015

ABSTRACT

Objectives: To investigate factors contributing to neonatal admission outcomes at Effia Nkwanta Regional Hospital (ENRH) Method: All neonatal admissions to the Neonatal & Intensive Care Unit (NICU) of the hospital that were entered into the DHIMS2 database were extracted and complemented with additional information from patients' folder review. The data from the two sources were merged and analysed using SPSS version 21. Univariate and multivariate regression analysis was performed to identify factors associated with admission outcomes, taking statistical significance as p < 0.05. ARC-GIS version 10.1 was used to describe the geospatial distribution of health facilities referring to ENRH. Setting: Neonatal & Intensive Care Unit of ENRH Participants: All neonates admitted to NICU between January and December 2015. Intervention None Results: Nine Hundred and Ninety-Three out of the 1150 neonatal admissions were entered into DHIMS2. Fifty-two percent were males, 57.3% were delivered through Caesarean Section, 72% were admitted within 2 days of birth, and 56.8% had normal birth weight. FiftyEight percent of the neonates were delivered at the ENRH, whilst 39.9% were referred from health facilities located within Sekondi-Takoradi Metropolis. At 1 minute, only 14% of the neonates had normal Apgar score (8-10), and this improved to 50% at 5 minutes. The main causes of neonatal admission were birth asphyxia 21.0%, followed by prematurity 17.5%, neonatal jaundice 17.1% and neonatal sepsis 14.5%. The death rate was 18% with more than 80% of the deaths occurring during the early neonatal period. More than 80% of deaths were due to four admission diagnoses birth asphyxia, prematurity, neonatal jaundice, neonatal sepsis. Factors associated with adverse admission outcome are low birth weight, delivery by Caesarean Section and low Apgar score at 5 minutes. Conclusions: The institution of appropriate interventions to reduce or manage the four major causes of adverse neonatal admission outcomes will significantly reduce neonatal mortality in the hospital