Original Article

Journal of Perinatology (2008) 28, 561–565; doi:10.1038/jp.2008.61; published online 19 June 2008

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

C C Enweronu-Laryea1, K Nkyekyer2 and O P Rodrigues3

  1. 1Department of Child Health, University of Ghana Medical School, Accra, Ghana
  2. 2Department of Obstetrics and Gynecology, University of Ghana Medical School, Accra, Ghana
  3. 3Department of Child Health, University of Ghana Medical School, Accra, Ghana

Correspondence: Dr CC Enweronu-Laryea, Department of Child Health, University of Ghana Medical School, PO Box 4236, Accra, Ghana. E-mail: chikalaryea@yahoo.com

Received 5 November 2007; Revised 18 April 2008; Accepted 21 April 2008; Published online 19 June 2008.

Top

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 greater than or equal to2500 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 greater than or equal to2500 g.

Conclusion:

 

Improved facilities significantly improved survival of newborns <2500 g, but was of no benefit for newborns greater than or equal to2500 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.

Keywords:

birth weight, survival, birth asphyxia, out-born, inborn

Extra navigation

.

naturejobs

More science jobs
Post a job for free
ADVERTISEMENT