Prevention Of Neonatal Mortality Research Articles

Maternity Behavior and Infant Care of Coastal Communities on the Prevention of Neonatal Mortality

Background: Infant mortality is one of the targets of health problems in sustainable development. The vast majority of infant deaths are preventable, with high-quality, evidence-based interventions in the form of data. Based on the results of the Indonesian Demographic and Health Survey (SDKI) infant mortality in 2017 was 24/1,000 KH with neonatal mortality of 15/1,000. There was a decrease in the infant mortality rate (IMR) in 2017, compared to the IMR in 2012 which amounted to 32/1,000 KH and 19/1,000 KH neonatal. This study aims to analyze the behavior of childbirth and infant care through the behavior of local wisdom so as to prevent neonatal death. Methods: This study uses a quantitative observational method through a Case Control Study Design approach. The population in this study were all mothers in the coastal area of the Konawe Islands Regency. Results: Birth behavior and baby care at risk provide opportunities for neonatal events. Health agencies need to increase education to the public about risk factors, causes of neonatal death and efforts to prevent neonatal death to mothers and expectant mothers and their families to pay attention to pregnant and postpartum women. Conclusion: For the community, it is necessary to regulate the age of marriage with efforts to control it from the local government

PEDIATRIC HEALTHCARE SERVICE FOR AS A PART OF INDONESIAN FUTURE

Continuing and accelerating child health are issues stated in Sustainable Development Goals (SDG) by United Nation (UN). Targets in improving child health in SDG are by decreasing neonatal and pediatric mortality. Reducing risk and prevention of neonatal mortality may be achieved by monitoring intrauterine fetal development. High burden of pediatric mortality may be seen in pediatric genetic, neoplasm and infectious disease. In this COVID-19 pandemic era, SARS-COV2 infection in children add more challenge in improving child health. In this issue, we proudly present articles on pediatric genetic, neoplasm and infectious disease especially in clinical manifestation, diagnostic and therapeutic challenge.

MATERNAL AWARENESS, PERCEIVED DISPOSITION AND HABIT DETERMINANTS TO NEONATAL MORTALITY AMONG MOTHERS DELIVERING AT A COUNTY REFERRAL HOSPITAL, KENYA

Purpose: The study sought to establish the maternal awareness, perceived disposition and habit determinants to neonatal mortality among mothers delivering at a County Referral Hospital, Kenya. 
 Design: A descriptive cross-sectional hospital-based study. The study was carried out in Nakuru county referral Hospital, Kenya, in the postnatal wards in the maternity unit. Mothers who delivered and gave consent in the maternity unit in Nakuru county Referral Hospital were recruited. Mothers who did not deliver and were referred to Nakuru county referral hospital and declined to give consent were excluded from the study. The sample size was determined using Fisher et al 1999 formula. The targeted sample size was therefore 278 mothers. The study respondents were identified using systematic random sampling. Quantitative data was collected using a pre-tested questionnaire by the research assistants. Data was entered into the computer and analyzed using SPSS version 20. Univariate analysis was presented using descriptive statistics like graphs, bar charts, pie charts and tables. Bivariate analysis was presented using inferential statistics like chi square and probability estimations to test for significance.
 Results: Neonatal mortality was significantly associated with the maternal determinants. Maternal awareness (p=<0.001), disposition (p=0.001), habits (p=0.009)) all had significant relationships. From qualitative data, there was a linkage between neonatal deaths and cultural factors such as traditional practices and home delivery. Inadequate health care providers’ services, like lack of counseling to mothers on prevention of neonatal deaths before and after delivery, were strongly stated by the participants as being associated with neonatal deaths.
 Unique contribution to theory, practice and policy: The Health care providers should ensure that mothers are empowered with knowledge on prevention of neonatal mortality which should include counseling on risk factors during pregnancy and the health education should be spread from pregnancy to discharge and during follow-up visits.

Classic Congenital Adrenal Hyperplasia Due to 21-hydroxylase Deficiency - The Next Disease Included in the Neonatal Screening Program in Poland

Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. The most common form of CAH is caused by mutations in CYP21A, the gene encoding the adrenal steroid 21-hydroxylase enzyme. Deficiency of the enzyme leads to life-threatening adrenocortical insufficiency, which is not demonstrable during the first days of life. Additionally, some of the affected neonates have varying degrees of pathology of the external genitalia, classified as disorders of sex development (DSD). These make it difficult to recognize the sex of the affected neonate or lead to incorrect sex assignment.CAH has been included in neonatal screening programs in many countries of the world since the late of 1970s. The main benefit of the screening is early diagnosis and prevention of neonatal mortality in children with salt-wasting CAH. Early recognition of the disease is also helpful in correct sex assignment of DSD neonates.In 2016 Poland joined the group of countries which conduct neonatal screening for 21-hydroxylase deficient CAH and the condition is now included in the neonatal screening program. Therefore, it is possible to recognize the disease soon after birth in all Polish newborns and to start the prompt replacement steroid therapy. As the information on the suspicion or diagnosis of CAH in very young newborns has recently reached neonatologists, pediatricians, and general practitioners, and not only pediatric endocrinologists, the aim of this paper is to deliver the most necessary information on the disease to a wider group of doctors, not familiar with CAH.

The effect of cord cleansing with chlorhexidine on neonatal mortality in rural Bangladesh: a community-based, cluster-randomised trial

Up to half of neonatal deaths in high mortality settings are due to infections, many of which can originate through the freshly cut umbilical cord stump. We aimed to assess the effectiveness of two cord-cleansing regimens with the promotion of dry cord care in the prevention of neonatal mortality. We did a community-based, parallel cluster-randomised trial in Sylhet, Bangladesh. We divided the study area into 133 clusters, which were randomly assigned to one of the two chlorhexidine cleansing regimens (single cleansing as soon as possible after birth; daily cleansing for 7 days after birth) or promotion of dry cord care. Randomisation was done by use of a computer-generated sequence, stratified by cluster-specific participation in a previous trial. All livebirths were eligible; those visited within 7 days by a local female village health worker trained to deliver the cord care intervention were enrolled. We did not mask study workers and participants to the study interventions. Our primary outcome was neonatal mortality (within 28 days of birth) per 1000 livebirths, which we analysed on an intention-to-treat basis. This trial is registered with ClinicalTrials.gov, number NCT00434408. Between June, 2007, and September, 2009, we enrolled 29 760 newborn babies (10 329, 9423, and 10 008 in the multiple-cleansing, single-cleansing, and dry cord care groups, respectively). Neonatal mortality was lower in the single-cleansing group (22·5 per 1000 livebirths) than it was in the dry cord care group (28·3 per 1000 livebirths; relative risk [RR] 0·80 [95% CI] 0·65-0·98). Neonatal mortality in the multiple-cleansing group (26·6 per 1000 livebirths) was not statistically significantly lower than it was in the dry cord care group (RR 0·94 [0·78-1·14]). Compared with the dry cord care group, we recorded a statistically significant reduction in the occurrence of severe cord infection (redness with pus) in the multiple-cleansing group (risk per 1000 livebirths=4·2 vs risk per 1000 livebirths=1·2; RR 0·35 [0·15-0·81]) but not in the single-cleansing group (risk per 1000 livebirths=3·3; RR 0·77 [0·40-1·48]). Chlorhexidine cleansing of a neonate's umbilical cord can save lives, but further studies are needed to establish the best frequency with which to deliver the intervention. United States Agency for International Development and Save the Children's Saving Newborn Lives program, through a grant from the Bill & Melinda Gates Foundation.

The prevention of neonatal mortality from the standpoint of the obstetrician: Danforth, W. C. Illinois M. J. 46: 166, 1929

The prevention of neonatal mortality from the standpoint of the obstetrician: Danforth, W. C. Illinois M. J. 46: 166, 1929