Neonatal mortality trends at Al-Nasser paediatric hospital in Gaza, occupied Palestinian territory: a retrospective analysis of hospital records

Abstract

BackgroundNeonatal mortality accounts for nearly 60% of infant mortality, with this percentage slowly decreasing in developing countries. The aim of this study was to describe the pattern of neonatal mortality rates among neonates who were admitted to the neonatal intensive care unit (NICU) in Al-Nasser Paediatric Hospital (NPH) during a span of 2 years. MethodsThis was a retrospective descriptive study that included 2 years of data (from January 2011 to December 2012) of all neonatal admissions and deaths in the NICU in NPH collected from the medical records. Neonatal mortality rates in 2011 and 2012 were analysed, using R software (version 3.1.0). FindingsThe total number of neonatal admissions to hospital were 1541; 1915 during 2011 and 2012, respectively. 57 and 28 infants died during the each year. The total neonatal mortality rate (NMR) in 2011 (0·037 per 1000 admissions) was significantly higher than NMR in 2012 (0·0146 per 1000 admissions), with the difference being 0·0224 per 1000 admissions (95% CI 0·0114–0·0334, p<0·0001). The most common causes of neonatal deaths were prematurity and its complications followed by congenital anomalies. InterpretationNeonatal mortality in NPH in 2012 was reduced compared with 2011. Whether this reduction was due to renovation of the NICU, equipment improvement, new medical supplies, or improvement in data quality and registration system, or mostly due to human resources training for implementation of neonatal guidelines, is unclear. These findings would not necessarily represent overall changes in NMR between the 2 years since our data are only representative for neonates admitted to the NPH NICU. Further research about other NICUs in Gaza is warranted and could be easily undertaken when the registration systems in Palestinian paediatric hospitals are computerised, unified, and linked. This new system will be the first step to design and develop Gaza Neonatal Network to establish easy communication between NICU in other hospitals and to solve problems, consultation, and finally to estimate causes of NMR. FundingNone.