Neonatal death audits at Kgapane Hospital, Limpopo province

IF 1.2 Q2 MEDICINE, GENERAL & INTERNAL
Gert J.O. Marincowitz, C. Marincowitz
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Abstract

Background: Neonatal deaths (NNDs) are a global public health challenge, predominantly affecting low- and middle-income countries. The causes of most NNDs are preventable. Therefore, this study reviewed perinatal clinical audit data at Kgapane Hospital over a 4-year period with a special focus on the factors associated with NNDs.Methods: File audits were performed for all NNDs occurring at Kgapane Hospital and its catchment area from 2018 to 2021. The data from these audits were analysed to identify factors associated with NNDs.Results: The NND rate for the study period was 12.6/1000 live births. In this study (n = 236), 90% of the deaths could be associated with four factors, namely prematurity (44%); intrapartum complications (19%) including asphyxia, meconium aspiration and breech deliveries; neonatal infections (16%) of which human immunodeficiency virus (HIV) positivity was the most prevalent; and foetal congenital abnormalities (11%). The modifiable factors included inadequate intrapartum foetal monitoring; delays in management interventions; instances where no attempts were made to refer patients for specialised care, or where no beds were available at the next level of care; patient-related factors; and inadequate adherence to management protocols, such as for the management of prematurity and HIV.Conclusion: Understanding factors associated with NNDs can guide health worker training and improvement strategies to reduce this heart-breaking complication of pregnancy.Contribution: Family physicians working in rural hospitals are also responsible for newborn care. Understanding the factors associated with NNDs will guide them to focus training and develop improvement strategies to reduce these preventable deaths.
林波波省 Kgapane 医院新生儿死亡审计
背景:新生儿死亡(NNDs)是一项全球性的公共卫生挑战,主要影响中低收入国家。大多数新生儿死亡的原因都是可以预防的。因此,本研究回顾了 Kgapane 医院 4 年来的围产期临床审计数据,并特别关注与新生儿死亡相关的因素:从2018年至2021年,对Kgapane医院及其集水区发生的所有NND进行了档案审计。对这些审计数据进行分析,以确定与NND相关的因素:研究期间的 NND 率为 12.6/1000 例活产。在这项研究中(n = 236),90%的死亡与四个因素有关,即早产(44%);产时并发症(19%),包括窒息、胎粪吸入和臀位分娩;新生儿感染(16%),其中人类免疫缺陷病毒(HIV)阳性最为普遍;以及胎儿先天畸形(11%)。可改变的因素包括:产前胎儿监测不足;管理干预延误;未尝试将患者转诊至专业护理机构,或下一级护理机构没有床位;与患者有关的因素;以及未充分遵守管理规程,如早产儿和艾滋病毒管理规程:结论:了解与 NND 相关的因素可以指导医务工作者的培训和改进策略,从而减少这种令人心碎的妊娠并发症:贡献:在农村医院工作的家庭医生也负责新生儿护理。贡献:在农村医院工作的家庭医生也负责新生儿护理工作,了解与新生儿窒息相关的因素将指导他们开展重点培训并制定改进策略,以减少这些可预防的死亡。
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来源期刊
South African Family Practice
South African Family Practice MEDICINE, GENERAL & INTERNAL-
CiteScore
1.50
自引率
20.00%
发文量
79
审稿时长
25 weeks
期刊介绍: South African Family Practice (SAFP) is a peer-reviewed scientific journal, which strives to provide primary care physicians and researchers with a broad range of scholarly work in the disciplines of Family Medicine, Primary Health Care, Rural Medicine, District Health and other related fields. SAFP publishes original research, clinical reviews, and pertinent commentary that advance the knowledge base of these disciplines. The content of SAFP is designed to reflect and support further development of the broad basis of these disciplines through original research and critical review of evidence in important clinical areas; as well as to provide practitioners with continuing professional development material.
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