Neonatal Mortality and Morbidity in Regional Provincial Hospitals in the People’s Democratic Republic of Laos

Schmidt, Simone; Duangdala, Phouvieng; Saysanasongkham, Bounnack; Sabir, Hemmen; Brenner, Sebastian; Schmid, Manuel; Kuehn, Thomas; Hoehn, Thomas

doi:10.1093/tropej/fmv101

Cited by 8 publications

(10 citation statements)

References 7 publications

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“…Our research also affirms other studies which suggest there is often confusion among healthcare providers regarding the classification of stillbirth [4,6,7,[21][22][23]. Another study in Lao PDR of five hospitals examined the causes and incidences of neonatal diseases and deaths also found inconsistency in documentation, a lack of differentiation between stillbirths with maceration and intrapartum stillbirths and the potential for some neonatal deaths to have been misclassified as stillbirth [23].…”

Section: Discussionsupporting

confidence: 79%

Stillbirth in Lao PDR: a healthcare provider perspective

Choummanivong

Karimi

Durham

et al. 2020

Global Health Action

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Background: Stillbirth is a major global concern. However, most research has been conducted in high-income countries. Understanding of the experience and management of stillbirth in low-middle income countries is needed. Objective: This qualitative study explored health professionals' experiences of providing stillbirth care in the Lao People's Democratic Republic, a lower-middle-income country in SouthEast Asia. Methods: In-depth interviews were conducted with 33 health professionals (doctors, midwives and nurses) and thematic analysis was undertaken. Results: All participants acknowledged stillbirth as a concern, but its incidence and causes were largely undocumented and unknown. A lack of training in managing stillbirth left health professionals often ill-equipped to support mothers and provide responsive care. Social stigma surrounds stillbirth, meaning mothers found limited support or opportunities to openly express their grief. Conclusions: Better awareness of stillbirth causes could promote more positive experiences for healthcare providers and parents and more responsive healthcare. This requires improved training for healthcare professionals and awareness raising in the wider community.

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Section: Discussionsupporting

confidence: 79%

Stillbirth in Lao PDR: a healthcare provider perspective

Choummanivong

Karimi

Durham

et al. 2020

Global Health Action

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“…However, the overall proportion of deaths was similar in both hospitals with 8.94% at SJH and 8.91 at UWRH with no significant difference between the two (p = 0.980). This finding is comparable to other studies in similar settings; a regional hospital in Cameroon recorded 9.83%, a tertiary care centre in India reported 10.4%, two regional provincial hospitals in Laos reported 8.9% and 10% respectively [6,15,16]. The observation was however higher than the 1% reported by a district hospital in India and 2.3% and 6.8% reported by two of the regional provincial hospitals in Laos and the 6.0% reported at SJH in 2017 in this study [16,17].…”

Section: Plos Onesupporting

confidence: 88%

“…This finding is comparable to other studies in similar settings; a regional hospital in Cameroon recorded 9.83%, a tertiary care centre in India reported 10.4%, two regional provincial hospitals in Laos reported 8.9% and 10% respectively [6,15,16]. The observation was however higher than the 1% reported by a district hospital in India and 2.3% and 6.8% reported by two of the regional provincial hospitals in Laos and the 6.0% reported at SJH in 2017 in this study [16,17]. However, it was lower than the 15.7% reported by a regional hospital in Cameroon, 11.3%, reported by a tertiary hospital in Tanzania and 13.3% reported by a referral hospital in Ethiopia [18][19][20].…”

Section: Plos Onesupporting

confidence: 88%

The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study

Tette¹,

Nartey²,

Nuertey³

et al. 2020

PLoS ONE

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Background High global neonatal deaths have triggered efforts to improve facility-based care. However, the outcomes achievable at different levels of care are unclear. This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality. Objective This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality Methods A cross-sectional study involving a records-review over one year at the Upper West Regional Hospital, and three years at St Joseph's District Hospital, Jirapa was carried out. Age, sex, gestational age, weight, duration of admission, diagnosis, among others were examined. The data were analysed and statistical inference made.

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“…The profile of neonatal morbidity and mortality in Solomon Islands is comparable to other low‐ and low‐middle income countries where mortality is highest in low birthweight or pre‐term neonates, and most deaths occurring in the first days of life are from intrapartum complications . Other countries in the region face similar challenges.…”

Section: Discussionmentioning

confidence: 87%

Cause‐specific neonatal morbidity and mortality in the Solomon Islands: An assessment of data from four hospitals over a three‐year period

Tosif

Jatobatu²,

Maepioh³

et al. 2019

J Paediatrics Child Health

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Aim: Data on stillbirths and neonatal morbidity and mortality in low-middle income Pacific Island Nations such as Solomon Islands is limited, partly due to weak health information systems. We describe the perinatal mortality and clinical factors associated with poor newborn outcomes at four hospitals in Solomon Islands. Methods: This was a registry based retrospective cohort study at three provincial hospitals and the National Referral Hospital (NRH) from 2014-2016 inclusive. Results: 23 966 labour ward births and 3148 special care nursery (SCN) admissions were reviewed. Overall still birth rate was 29.2/1000 births and the perinatal mortality rate was 35.9/1000 births. PNMR were higher in provincial hospitals (46.2, 44.0 and 34.3/1000) than at NRH (33.3/1000). The commonest reasons for admission to SCN across the hospitals were sepsis, complications of prematurity and birth asphyxia. SCN mortality rates were higher in the 3 provincial hospitals than at NRH (15.9% (95/598) vs. 7.9% (202/2550), P value <0.01). At NRH, the conditions with the highest case fatality rates were birth asphyxia (21.3%), congenital abnormalities (17.7%), and prematurity (15.1%). Up to 11% of neonates did not have a diagnosis recorded. Conclusions: The perinatal mortality rates are high and intrapartum complications, prematurity and sepsis are the main causes of morbidity and mortality for neonates at hospitals in Solomon Islands. Stillbirths account for 81% of perinatal deaths. These results are useful for planning for quality improvement at provincial level. Improved vital registration systems are required to better capture stillbirths and neonatal outcomes.

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Neonatal Mortality and Morbidity in Regional Provincial Hospitals in the People’s Democratic Republic of Laos

Abstract: These data could be the basis for any teaching program aimed at reducing neonatal mortality. Furthermore, they enable an evaluation of the ongoing teaching program.

Cited by 8 publications

References 7 publications

Stillbirth in Lao PDR: a healthcare provider perspective

Stillbirth in Lao PDR: a healthcare provider perspective

The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study

Cause‐specific neonatal morbidity and mortality in the Solomon Islands: An assessment of data from four hospitals over a three‐year period

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