Abstract
Neonatal mortality has been decreasing slowly in Ghana despite investments in maternal-newborn services. Although community-based interventions are effective in reducing newborn deaths, hospital-based services provide better health outcomes. To examine the process and cost of hospital-based services for perinatal asphyxia and low birth weight/preterm at a district and a regional level referral hospital in Ghana. A cross-sectional study was conducted at 2 hospitals in Greater Accra Region during May-July 2016. Term infants with perinatal asphyxia and low birth weight/preterm infants referred for special care within 24hours after birth were eligible. Time-driven activity-based costing (TDABC) approach was used to examine the process and cost of all activities in the full cycle of care from admission until discharge or death. Costs were analysed from health provider's perspective. Sixty-two newborns (perinatal asphyxia 27, low-birth-weight/preterm 35) were enrolled. Cost of care was proportionately related to length-of-stay. Personnel costs constituted over 95% of direct costs, and all resources including personnel, equipment and supplies were overstretched. TDABC analysis revealed gaps in the organization, process and financing of neonatal services that undermined the quality of care for hospitalized newborns. The study provides baseline cost data for future cost-effectiveness studies on neonatal services in Ghana. Authors received no external funding for the study.
Highlights
Infant mortality rate, infant deaths per 1000 live births, is an indicator of the health and wellbeing of nations
During the 3 months, 869 newborns were admitted to both hospitals and 496 were eligible for the study
Data was collected from 62 babies of 58 mothers comprising 27 cases of perinatal asphyxia and 35 cases of low birth weight (LBW)/preterm
Summary
Infant deaths per 1000 live births, is an indicator of the health and wellbeing of nations. Most infant deaths occur in the first 28 days after birth – the newborn period, and an estimated 2.6 million newborns died in 2016.1 Most newborn deaths are preventable and the major causes are perinatal asphyxia, low birth weight (LBW)/preterm birth, and infections.[2] Community-based maternal-newborn interventions are cost-effective strategies for reducing newborn deaths,[3,4,5] but hospital-based services lead to better health outcomes.[6,7]. In Ghana, perinatal asphyxia and LBW/preterm are leading causes of neonatal mortality and all-cause mortality, but the burden of neonatal infections is uncertain due to challenges in accurate diagnosis.[8,9] Neonatal mortality rate has been declining relatively very slowly[10] despite investments in infrastructure, developmental assistance from partners, and a National Health Insurance Scheme (NHIS) that provides free hospital-based maternal-newborn services. The NHIS is a nationwide social health insurance scheme with a fee for service (FFS) payment mechanism for medicines
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
