Prevalence of asphyxia and readiness for neonatal resuscitation in Kenya

Abstract

Background: Birth asphyxia accounts for one-third of neonatal mortality worldwide. Aims: To determine the prevalence of birth asphyxia and associated risk factors at one Kenyan hospital; and to describe caregivers' readiness for and attitudes towards neonatal resuscitation of asphyxiated neonates. Methods: A total of 237 babies and 28 health workers were consecutively enrolled as part of a longitudinal cross-sectional study. Prevalence of asphyxia, and caregivers' practices and attitudes were measured through observation. Risk factors were identified through interviews with mothers and a review of their medical records. Findings: Birth asphyxia prevalence hospital was 5.1%. Independent predictors of birth asphyxia were: duration of labour (OR=3.86; 95% CI; P=0.041), meconium staining of amniotic fluid, and presence of oedema in pre-eclampsia. Conclusions: Having equipment alone is not enough if providers are not equipped to use it. Neonatal resuscitation skils are therefore vital to eliminating neonatal mortality.

Quality of Care during Neonatal Resuscitation in Kakamega County General Hospital, Kenya: A Direct Observation Study

“…Inappropriate positioning of the baby's airway, turning baby upside down, and hyperextending the jaw were observed in a considerable number of newborns. These harmful practices have also been reported in previous studies conducted in the country [ 24 , 25 , 35 ]. This indicates that despite all of the HCPs at least having some form of NR training, there is need for further emphasis on practical NR training to help eradicate some of these potentially harmful practices during NR.…”

“…This finding showed that the hospital is well prepared and ready for NR services although HCPs still miss out on key aspects of resuscitation care: removing the wet towel after drying the newborn, suctioning meconium before stimulation/drying the newborn, and initiation BMV within the Golden minute. This points to the need for proper training of HCPs having the equipment for improved NR performance as recommended by other studies in the country [ 25 , 35 ].…”

“…Checking the airway for secretions and clearance of obstructive secretions for babies who fail to initiate spontaneous breathing after drying was done for almost all newborns who did not respond after drying as recommended [ 29 ]. However, our findings demonstrated that NR skills were poor in airway clearance in presence of meconium, a predictor of birth asphyxia [ 24 , 25 , 35 ]. HCPs dried/stimulated newborns before airway clearance in presence of meconium in nonbreathing newborns as recommended by both the national and the international guidelines [ 16 , 29 , 30 ].…”

Evaluating Neonatal Resuscitation Skills of Practicing Nurses and Midwives in Selected Hospitals in Central Uganda

“…In many cases, neonatal resuscitation is a primary requirement for life, especially for neonates with birth asphyxia [1][2][3]. Neonatal resuscitation is particularly important as the first few days following birth are deemed the most vulnerable [4][5][6].…”

Evaluating Neonatal Resuscitation Skills of Practicing Nurses and Midwives in Selected Hospitals in Central Uganda​

“…In many cases, neonatal resuscitation is a primary requirement for life, especially for neonates with birth asphyxia (Gichogo, Murila, Matiang'i, Ndege, & Bosire, 2018;Pejovic et al, 2018;Wall et al, 2009). Neonatal resuscitation is particularly important as the first few days following birth are deemed the most vulnerable (Babaei & Dehghan, 2018;Owusu, Lim, Makaje, Wobil, & SameAe, 2018;UNICEF, 2015).…”