OBJECTIVE: To evaluate impact of simple interventions on neonatal mortality in a low-resource teaching hospital in India. STUDY DESIGN: Before-and-after intervention trial setting: limited resource teaching hospital; DESIGN: Before and after study. INTERVENTIONS: A package of simple interventions was evolved. The interventions included: rational admissions and early discharge, entrusting mothers in care-giving, enforcing asepsis routines, aggressive enteral feeding, abandoning unnecessary interventions, protocol-based management, rational antibiotics and training and empowerment of nurses. STATISTICAL METHODS: The categorical and continuous variables were compared with chi (2) and two-tailed tests, respectively. RESULTS: Neonatal mortality rate declined significantly during the intervention period as compared to control period (20.3 versus 29.3 per 1000 live births; relative risk 0.69, 95% confidence interval (CI) 0.57 to 0.85). Most significant decline occurred in sepsis-related deaths. The survival of neonates with birth weight 1000 to 1499 improved over two folds (56.7% versus 24.5%, P<0.01). There was a significant decline in antibiotics use (635/878, 72.3% versus 299/897, 23.2%; P=0.00). The duration of stay in neonatal unit was decreased by a mean of 1.5 day (95% CI 0.9 to 2.8 days) after interventions. CONCLUSIONS: Simple interventions can result in a significant decline in neonatal mortality in hospitals with limited resources. This package is likely to be effective in hospitals with a high proportion of the sepsis deaths.
OBJECTIVE: To evaluate impact of simple interventions on neonatal mortality in a low-resource teaching hospital in India. STUDY DESIGN: Before-and-after intervention trial setting: limited resource teaching hospital; DESIGN: Before and after study. INTERVENTIONS: A package of simple interventions was evolved. The interventions included: rational admissions and early discharge, entrusting mothers in care-giving, enforcing asepsis routines, aggressive enteral feeding, abandoning unnecessary interventions, protocol-based management, rational antibiotics and training and empowerment of nurses. STATISTICAL METHODS: The categorical and continuous variables were compared with chi (2) and two-tailed tests, respectively. RESULTS: Neonatal mortality rate declined significantly during the intervention period as compared to control period (20.3 versus 29.3 per 1000 live births; relative risk 0.69, 95% confidence interval (CI) 0.57 to 0.85). Most significant decline occurred in sepsis-related deaths. The survival of neonates with birth weight 1000 to 1499 improved over two folds (56.7% versus 24.5%, P<0.01). There was a significant decline in antibiotics use (635/878, 72.3% versus 299/897, 23.2%; P=0.00). The duration of stay in neonatal unit was decreased by a mean of 1.5 day (95% CI 0.9 to 2.8 days) after interventions. CONCLUSIONS: Simple interventions can result in a significant decline in neonatal mortality in hospitals with limited resources. This package is likely to be effective in hospitals with a high proportion of the sepsis deaths.
Authors: Rens Zonneveld; Natanael Holband; Anna Bertolini; Francesca Bardi; Neirude P A Lissone; Peter H Dijk; Frans B Plötz; Amadu Juliana Journal: BMC Pediatr Date: 2017-11-14 Impact factor: 2.125
Authors: Nabila Zaka; Emma C Alexander; Logan Manikam; Irena C F Norman; Melika Akhbari; Sarah Moxon; Pavani Kalluri Ram; Georgina Murphy; Mike English; Susan Niermeyer; Luwei Pearson Journal: Implement Sci Date: 2018-01-25 Impact factor: 7.327
Authors: Alexandra Molina García; James H Cross; Elizabeth J A Fitchett; Kondwani Kawaza; Uduak Okomo; Naomi E Spotswood; Msandeni Chiume; Veronica Chinyere Ezeaka; Grace Irimu; Nahya Salim; Elizabeth M Molyneux; Joy E Lawn Journal: EClinicalMedicine Date: 2022-01-10