Neonatal Mortality in Edward Francis Small Teaching Hospitals (EFSTH) Banjul, The Gambia, 2021: a need for neonatal mortality surveillance?

Abstract

Background: Neonatal mortality surveillance has not been prioritized in The Gambia, despite the global target of the SDGs to reduce Neonatal Mortality Rate to <12/1000 livebirth by 2030. We conducted this study to describe the epidemiology of neonatal mortality in Edward Francis Small Teaching Hospital in the Gambia January to December 2021.Methods: We conducted a cross sectional study in (EFSTH) among neonates who died within the period under study. We extracted data from various sources in the hospital. We analyzed demographic variables, listed sources of data, and determined risk factors for death at 95% confidence interval. Results: Of the 306 neonatal deaths in 2021, 161 (52.6%) were female, the median age is 2.4 days at a range of 0.04-26 days. Majority 242 (79.1%) of the neonates that died in EFSTH were delivered via vagina spontaneously. There were more 174 (56.9) preterm and 95 (35.3%) very low birth weight babies. The highest cause of death was pneumonia among 82 (26.8%), while highest non-infectious cause of death was asphyxia accounting for 29 (9.5%) deaths. Male neonates and neonates born in Western regions (Western1 & 2) are more likely to die of infectious causes compared to those from other 5 regions [POR:1.36 (CI= 0.8513-2.1679)] and [POR 0.57 (CI= 0.2650-1.2120)] respectively. These possible risk factors are not statistically significant. Sources of data varies for each hospital: case folders, admission registers, hospital database and death certificates. Conclusion: We found that the neonatal mortality rate for the hospital is higher than the national one. More female neonates die and majority of the mortalities occur within the first day of life. More deaths occur in the Western Regions who are less likely to die of infectious causes as compared to other regions. The leading causes of deaths among neonates were found to be pneumonia, sepsis, low birth weights among others.

Longterm Optimization Model for the Gambia’s Energy Transition

“…Furthermore, we have also adopted a longer time horizon in our model than the previous studies mentioned. This is important because 2050 is a period consistent with the Gambia's long term climate change strategy as well as the Gambia's long-term development vision (2050) [13], currently under development by the ministry of finance and economic affairs.…”