The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study.

Edem M A Tette,Naa Barnabas Gandau,Benjamin D Nuertey,Dominic Akaateba

doi:10.3390/children7030022

Edem M A Tette, Naa Barnabas Gandau + Show 2 more

Open Access

https://doi.org/10.3390/children7030022

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Abstract

Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.

Highlights

Child mortality is largely due to deaths occurring in the newborn period or the first 28 days of life [1]
These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, many of them were compromised especially those who died
This poses many challenges including a financial burden on families, long travel distances which may lead to incomplete referrals and poor outcomes [19,20,29]

Summary

Introduction

Child mortality is largely due to deaths occurring in the newborn period or the first 28 days of life [1]. In 2015, global neonatal deaths accounted for 45% of deaths in children under the age of five years and are projected to increase to 52% by 2030 [2]. Considerable emphasis has been placed on improving facility-based care for newborns [3,4,5]. Patient outcomes are known to be related to the distance patients travel to access care. Several studies have shown that outcomes worsen with increasing distance from a patient’s residence [6,7]. Neonates are vulnerable to the distances they have to travel to receive care as their condition often deteriorates rapidly [6,8,9]. It is imperative that neonates receive the necessary specialised care as quickly and as close to their residence as possible [6,9]

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