Abstract
Background: Postnatal transfer (PT) is interhospital transport of care-needing newborns. In 2016, a perinatal network was implemented to facilitate PT in the town of Douala, Cameroon. The network was supposed to improve PT-related care standards. This study aimed at determining characteristics of PT five years following the implementation of this network. Methods: A cross-sectional study was carried out from February to May 2021 at neonatology wards of six hospitals in Douala. Medical records of newborns transferred to the hospitals were scrutinized to document their characteristics. Parents were contacted to obtain information on PT route and itinerary. Data were analyzed using Epi Info software and summarized as percentages, mean and odds ratio. Results: In total, 234 of the 1159 newborns admitted were transferred, giving a PT prevalence of 20.2% (95% CI 17.9% - 22.6%). Male-to-female ratio of the transferred newborns was 1.3. Neonatal infection (26.5%), prematurity (23.5%) and respiratory distress (15.4%) were the main reasons for transfer. Only 3% of the PT was medicalized while only 2% of the newborns were transferred through perinatal network. On admission, hypothermia and respiratory distress were found in 31% and 35% of the newborns, respectively. The mortality rate among babies was 20% and these had a two-fold risk of dying (95% CI 1.58 - 3.44, p Conclusion: PT and the perinatal network are lowly organized and implemented in Douala. Sensitization of medical staff on in utero transfer, creating center for coordination of the network, and implementation of neonatal transport system could improve the quality of PT.
Highlights
According to the World Health Organization (WHO), neonatal period goes from birth to 28th day of life [1]
3% of the Postnatal transfer (PT) was medicalized while only 2% of the newborns were transferred through perinatal network
Douala Laquintinie hospital (DLH) is a second category hospital with 8 baby incubators, 24 cradles and 4 pediatricians. These three health facilities (HF) receive most of transferred newborns in Douala as they have the best and well-equipped maternities and neonatology services allowing for management of newborns in critical state
Summary
According to the World Health Organization (WHO), neonatal period goes from birth to 28th day of life [1]. Transfer relies on a gradation of care services and the main reasons for PT include prematurity, neonatal infections and surgical pathologies [3] [4]. In 2019, prevalence of PT was 20% in Japan with perinatal network and medicalized transport used in 62% and 92 of the transfers, respectively [9]. Neonatal infection (26.5%), prematurity (23.5%) and respiratory distress (15.4%) were the main reasons for transfer. 3% of the PT was medicalized while only 2% of the newborns were transferred through perinatal network. Conclusion: PT and the perinatal network are lowly organized and implemented in Douala.
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