Thandi Maya Gondwana de Wit, Tanya Doherty, Michael Hendricks
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引用次数: 0
Abstract
Background: Neonatal mortality remains a global health concern. In South Africa, 32% of under-five mortality consists of neonates, with 48% of neonatal deaths attributed to prematurity. The Home and Community-Based Services (HCBS) aim to reduce deaths of very low birth weight (VLBW) neonates through community health worker (CHW) home visits.
Objectives: This study aimed to describe a cohort of VLBW neonates discharged from a regional hospital including their community follow-up, clinical outcomes and caregivers' perceptions of the HCBS.
Methods: This was a descriptive mixed methods study. Routine hospital health information from 1 January to 31 December 2018 was analysed to describe the cohort. The referral pathway and follow-up were assessed through stakeholder meetings and analysing referral forms. Caregivers were interviewed for HCBS data.
Results: There were 169 VLBW neonates. The mean (SD) gestational age was 30 (±2.21) weeks, and the median (IQR) birthweight was 1210 g (1045-1390 g). At delivery, 85% had respiratory distress and 64% had presumed sepsis. Maternal characteristics included primigravida deliveries (15%), smoking (11%), alcohol use (9%) and teenage pregnancy (5%); 14% required social worker referral. Folder reviews showed referral plans for 49 (43.4%); however, 20 (17.7%) forms were received by HCBS. All five of the interviewed caregivers had positive perceptions of the HCBS.
Conclusion: This study demonstrated a high burden of medically and socially vulnerable VLBW neonates discharged from a regional hospital. Even with established HCBS systems, few VLBW neonates were followed up at home. For the HCBS to be fully effective, promotion, strengthening and monitoring of the referral system are required.
期刊介绍：
Global Health Action is an international peer-reviewed Open Access journal affiliated with the Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine at Umeå University, Sweden. The Unit hosts the Umeå International School of Public Health and the Umeå Centre for Global Health Research.
Vision: Our vision is to be a leading journal in the global health field, narrowing health information gaps and contributing to the implementation of policies and actions that lead to improved global health.
Aim: The widening gap between the winners and losers of globalisation presents major public health challenges. To meet these challenges, it is crucial to generate new knowledge and evidence in the field and in settings where the evidence is lacking, as well as to bridge the gaps between existing knowledge and implementation of relevant findings. Thus, the aim of Global Health Action is to contribute to fuelling a more concrete, hands-on approach to addressing global health challenges. Manuscripts suggesting strategies for practical interventions and research implementations where none already exist are specifically welcomed. Further, the journal encourages articles from low- and middle-income countries, while also welcoming articles originated from South-South and South-North collaborations. All articles are expected to address a global agenda and include a strong implementation or policy component.
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