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The impact of improved neonatal intensive care facilities on referral pattern and outcome at a teaching hospital in Ghana

Journal of Perinatology volume 28, pages 561–565 (2008)Cite this article

Abstract

Objective:

Evaluate the impact of improved neonatal intensive care facilities on survival and referral patterns at a teaching hospital in Ghana.

Study Design:

Retrospective cohort comparing birth weight-specific survival and referral pattern of newborns requiring intensive care before and after improvement of facilities.

Result:

Improved survival of newborns <2500 g especially those 1000–1499 g (OR=1.74 (CI 1.38–2.20; P<0.00001) for inborn, OR=2.16 (CI 1.36–3.44; P=0.0006) for out-born). Birth asphyxia, the major indication for ⩾2500 g newborn referrals, was associated with reduced survival (OR=0.56 (95% CI 0.40 to 0.78; P=0.0004)). There was fourfold increased referral of out-born ⩾2500 g.

Conclusion:

Improved facilities significantly improved survival of newborns <2500 g, but was of no benefit for newborns ⩾2500 g. A scaling-up approach with investments that improve emergency obstetric services, referral systems, human resources and neonatal resuscitation practices will save more newborn lives.

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Acknowledgements

The authors reviewed the statistics and received no financial support for this work.

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Authors and Affiliations

  1. Department of Child Health, University of Ghana Medical School, Accra, Ghana

    C C Enweronu-Laryea

  2. Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana

    K Nkyekyer

  3. Department of Child Health, University of Ghana Medical School, Accra, Ghana

    O P Rodrigues

Authors
  1. C C Enweronu-Laryea
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  2. K Nkyekyer
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  3. O P Rodrigues
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Correspondence to C C Enweronu-Laryea.

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Enweronu-Laryea, C., Nkyekyer, K. & Rodrigues, O. The impact of improved neonatal intensive care facilities on referral pattern and outcome at a teaching hospital in Ghana. J Perinatol 28, 561–565 (2008). https://doi.org/10.1038/jp.2008.61

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