Quality of neonatal resuscitation in Ethiopia: implications for the survival of neonates

Abstract

Background: Birth asphyxia accounts for one-quarter newborn deaths. Providing quality care service of neonatal resuscitation reduces neonatal mortality. However, challenges to providing quality neonatal resuscitation are not well investigated in Ethiopia. Hence, this study is conducted to assess the quality provision of neonatal resuscitation in Ethiopia. Method: We used data from the Ethiopian 2016 Emergency Obstetric Newborn Care survey, conducted in 3804 health facilities providing maternal and newborn health services. We described the quality of neonatal resuscitation services according to the structure, process and outcome triad of quality dimension. Data from registers and birth records for the last 12 months prior to the survey were extracted. In each facility, the three last eligible charts of resuscitated neonates were reviewed and the highest frequency of chart of resuscitated baby was considered to the analysis. Thus, a total of 555 charts were assessed. Logistic regression model was used to assess the relationship between the neonatal resuscitation processes, provider, facility and newborn characteristics with neonatal outcome at the time of discharge. Results: The finding suggested that, around two-third, 364(65.6%) of the asphyxiated babies resuscitated by bag and mask type of neonatal resuscitation. Of the babies who had got neonatal resuscitation 463 (83.4%) survived. Resuscitated neonates with a gestational age of greater than 37 weeks and above (Adjusted Odds Ratio (AOR) =1.82; 95% Confidence Interval (CI) (1.09-3.04)), availability of priority equipment in health facilities for neonatal resuscitation (AOR = 1.24, 95% CI (1.09, 1.54)) and women who had 12 h and less duration of labor (AOR = 1.76; 95% CI (1.23, 3.13)) were the independent factors of survival of the neonate. Conclusion: Only half of the health facilities were ready for neonatal resuscitation (NR) in terms of priority equipment's. However, eight out of ten babies survived after NR in Ethiopia. Gestational age, priority equipment for NR and duration of labor were determinants of survival of resuscitated neonates in Ethiopia. Therefore, the availability of priority equipment and attentive care and follow-up for premature neonates and those face prolonged labor need to be improved in Ethiopia.

<p>Preterm Neonatal Mortality and Its Determinants at a Tertiary Hospital in Western Uganda: A Prospective Cohort Study</p>

“…47 Similar to other studies, mortality of preterm neonates was inversely proportional to gestational age. 13,22,48,49 Lower gestational age was significantly associated with increased likelihood of having complications such as RDS, apnea, and hypothermia. This suggests that prevention of these complications may result in increased survival of babies born too soon.…”

Incidence and Predictors of Mortality Among Neonates with Perinatal Asphyxia, Northwest Ethiopia, 2021: An Institution Based Retrospective Cohort Study.

“…Moreover, The discrepancy might be variation in different studies was due to different operational de nitions for birth asphyxia and adopted by different researchers (30,33,34,39,50). Moreover, this high death emanated from the poor neonatal resuscitation skills, the lack of resuscitative equipment, lack of skilled manpower in neonatal resuscitation at birth and delay in transporting the asphyxiated newborn to a higher health facilities (51,52).…”

“…The possible reason might be once HIE stage II and III occur, they result in poor feeding, seizure, brain damage, and multiorgan dysfunction. In addition, due to lack of feasible, cost-effective care like therapeutic hypothermia, supportive management of seizure and adequate resuscitation in developing countries including Ethiopia (51,64). Besides, the probability that infants with the greatest hypoxic-ischemic brain damage will bene t least by any speci c intervention (65, 66).…”

Assessment of neonatal resuscitation skills among healthcare workers in Uasin Gishu County, Kenya

“…Similarly, some facilities in Ethiopia and Vietnam lacked towels and clocks, respectively. 24 , 25 Availability of essential equipment has been linked with increased survival of neonates after neonatal resuscitation. 24 Therefore, our evaluation reveals the need for better provision of all essential resuscitation equipment among non-tertiary hospitals in order to improve the survival rate of neonates.…”