Abstract
To review admissions and deaths at the neonatal intensive care unit (NICU) of the Korle Bu Teaching Hospital (KBTH), Ghana from 2011 to 2015, for the purposes of documentation of outcomes and identification of areas for improvement. A retrospective descriptive study of NICU Admissions & Discharges from 2011 to 2015. All data in the NICU Admissions & Discharge books were transferred into a spreadsheet and analysed. The NICU of KBTH provides secondary and tertiary care for premature and critically ill term babies in the southern half of Ghana. Over the 5-year period, 9213 babies were admitted to the NICU. Admission weights ranged from 300 to 6700g with median of 2400g. Overall mortality rate was 19.2%. Mortality rates were progressively and significantly higher in babies with lower admission weights and earlier gestations. We report a high NICU mortality rate of 19.2%, compared to the worldwide range of 3.1% to 29%. This wide range of outcomes is attributable to differences in the severity of illness of patients and to the organisation of resources devoted to obstetric and neonatal care. To substantially improve perinatal and neonatal outcomes, there is a need for wider coverage and better quality of health care; and to consider rationing of care. Complex interventions are necessary to improve outcomes, not just an increase in the allocation of particular resources. None declared.
Highlights
The measurement of institutional neonatal admissions and mortality is important for several reasons - to document workload and outcomes, to compare with past performance and with other institutions, to help identify potential areas for improvement, to show whether allocated resources are being effectively utilised, and to make a case for more resources.The Neonatal Intensive Care Unit (NICU) of the KorleBu Teaching Hospital (KBTH) in Ghana provides care for premature and critically ill term babies
The aim of this study was to review the numbers of admissions and deaths at the NICU of the Korle Bu Teaching Hospital, from 2011 to 2015, for the purposes of documentation, analysis of associated factors, dissemination, and the provision of data to facilitate planning and improvement of neonatal outcomes
The number of admissions to the NICU was directly related to the number of deliveries conducted in the Obstetrics Department of the Korle-Bu Teaching Hospital, which was the source of the majority (76%) of NICU admissions
Summary
The Neonatal Intensive Care Unit (NICU) of the KorleBu Teaching Hospital (KBTH) in Ghana provides care for premature and critically ill term babies. The mortality rate in a neonatal unit reflects quality of care but is profoundly affected by the severity of illness of neonates offered for admission. These two factors are in turn determined by national resource allocation to health and education, by the effectiveness of obstetric services, and by individual patient factors including congenital anomalies, maternal health, financial and educational status.[1]
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