Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

Abstract

Background: Unlike the infant mortality rate, the rate of neonatal mortality has not significantly declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. Prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI): 2.07–9.84), no education (aOR 2.16; 95% CI 1.12–4.14), multiparity (aOR 0.52; 95% CI 0.32–0.86), and caesarean section (aOR 0.44: 95% CI 0.19–0.99) were associated with NNM. Conclusions: Prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Women in referral hospitals should have safer access to caesarean section and be prepared for NICU intervention to save mothers and their newborns.

Refractive Error among Children Visiting the Department of Paediatric Opthalmology of a Tertiary Eye Care Center

“…10 The prevalence of refractive error in this study is 18.5%, which is higher than the study done in Palpa (9%). 11 Compared to a study done in 15000 children in 2010, myopia was predominant among males and hyperopia was predominant among females, however, this study of 3600 students Myopia was predominant among both males and females followed by astigmatism and hyperopia. 12 Similarly in a study conducted in 2015 in the Terai region astigmatism was higher among children.…”