Dataset Information

Impact of secondary and tertiary neonatal interventions on neonatal mortality in a low- resource limited setting hospital in Uganda: a retrospective study.

ABSTRACT:

Objective

To assess the impact of secondary and tertiary level neonatal interventions on neonatal mortality over a period of 11 years.

Design

Interrupted time series analysis.

Setting

Nsambya Hospital, Uganda.

Interventions

Neonatal secondary interventions (phase I, 2007-2014) and tertiary level interventions (phase II, 2015-2020).

Participants

Neonates.

Primary and secondary outcome measures

Primary outcome: neonatal mortality.

Secondary outcome

case fatality rate (CFR) for prematurity, neonatal sepsis and asphyxia.

Results

During the study period, a total of 25 316 neonates were admitted, of which 1853 (7.3%) died. The average inpatient mortality reduced from 8.2% during phase I to 5.7% during phase II (p=0.001). The CFR for prematurity reduced from 16.2% to 9.2% (p=0.001). There was a trend in reduction for the CFR of perinatal asphyxia from 14.9% to 13.0% (p=0.34). The CFR for sepsis had a more than a twofold increase (3%-6.8% p=0.001) between phase I and phase II.

Conclusion

Implementation of secondary and tertiary neonatal care in resource-limited settings is feasible. This study shows that these interventions can significantly reduce the neonatal mortality, with the largest impact seen in the reduction of deaths from perinatal asphyxia and prematurity. An increase in sepsis related deaths was observed, suggesting emphasis on infection control is key.

SUBMITTER: Kirabira VN

PROVIDER: S-EPMC9379481 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Impact of secondary and tertiary neonatal interventions on neonatal mortality in a low- resource limited setting hospital in Uganda: a retrospective study.

Kirabira Victoria Nakibuuka VN Nakaggwa Florence F Nazziwa Ritah R Nalunga Sanyu S Nasiima Ritah R Nyagabyaki Catherine C Sebunya Robert R Latigi Grace G Pirio Patricia P Ahmadzai Malalay M Ojom Lawrence L Nabwami Immaculate I Burgoine Kathy K Blencowe Hannah H

BMJ open 20220811 8

<h4>Objective</h4>To assess the impact of secondary and tertiary level neonatal interventions on neonatal mortality over a period of 11 years.<h4>Design</h4>Interrupted time series analysis.<h4>Setting</h4>Nsambya Hospital, Uganda.<h4>Interventions</h4>Neonatal secondary interventions (phase I, 2007-2014) and tertiary level interventions (phase II, 2015-2020).<h4>Participants</h4>Neonates.<h4>Primary and secondary outcome measures</h4>Primary outcome: neonatal mortality.<h4>Secondary outcome</h4 ...[more]

PMID: 35953254

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Project description:BackgroundThe educational efficacy in neonatal resuscitation relies on the subject and teaching strategies. Therefore, it is imperative to test diverse educational methods if they are more instructive to engage students in active learning and practicing knowledge. Hence, the present study aims to investigate the efficacy of a pedagogical framework in neonatal resuscitation skill learning among nursing students in a resource-limited setting.MethodsA single-blind randomized controlled trial was conducted between October 2020 to March 2021. Sixty nursing students in the 3rd and 4th year of professional training were randomly allocated to the pedagogy and the traditional group. The pedagogy group learned via 6-step LSPPDM (Learn, See, Practice, Prove, Do, Maintain) pedagogy including lectures, video, clinical observation, skill sessions under supervision, and self-directed practice. The traditional group learned through 2-step (Learn, Practice) method that included lectures and skill sessions under supervision. The outcomes measured included technical and non-technical skills in neonatal resuscitation. The technical skill deals with steps such as stimulation, ventilation, oxygenation, intubation, chest compression, medications, and reporting. Non-technical skills refer to teamwork skills that focus on the interaction between leader and helper. Both skills were measured through previously published validated tools two times before and after the intervention by blinded assessors in a simulated delivery room.ResultsOverall, the skill was significantly improved in both groups after intervention. Yet, the results showed that the mean difference of technical skill score in the pedagogy group (24.3 ± 3.5) was significantly higher (p < 0.001) compared to the traditional group (16.2 ± 2.4). Likewise, the mean difference of non-technical skill score in the pedagogy (36.9 ± 1.9) was highly significant (p < 0.001) compared to the traditional group (31.2 ± 1.7).ConclusionsThe LSPPDM pedagogy was found more effective in enhancing technical and non-technical skills in neonatal resuscitation compared to the traditional method. The results of this study support the efficacy of the 6-step LSPPDM pedagogy in the education of nursing students regarding neonatal resuscitation in a resource-limited setting.Trial registrationProspectively registered at ClinicalTrials.gov ( NCT04748341 ).

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Dataset Information

Impact of secondary and tertiary neonatal interventions on neonatal mortality in a low- resource limited setting hospital in Uganda: a retrospective study.

Objective

Design

Setting

Interventions

Participants

Primary and secondary outcome measures

Secondary outcome

Results

Conclusion

Publications

Impact of secondary and tertiary neonatal interventions on neonatal mortality in a low- resource limited setting hospital in Uganda: a retrospective study.

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