Readiness to treat and factors associated with survival of newborns with breathing difficulties in Ethiopia

Abstract

Background Ethiopia is one of five countries that account for half of the world’s 2.6 million newborn deaths. A quarter of neonatal deaths in Ethiopia are caused by birth asphyxia. Understanding different dimensions of the quality of care for newborns with breathing difficulties can lead to improving service provision environments and practice. We describe facility readiness to treat newborns with breathing difficulties, the extent to which newborn resuscitation is provided, and by modeling the survival of newborns with difficulties breathing, we identify key factors that suggest how mortality from asphyxia can be reduced. Methods We carried out a secondary analysis of the 2016 Ethiopia Emergency Obstetric and Newborn Care Assessment that included 3804 facilities providing childbirth services and 2433 chart reviews of babies born with difficulties breathing. We used descriptive statistics to assess health facilities’ readiness to treat these newborns and a binary logistic regression to identify factors associated with survival. Results Over one-quarter of facilities did not have small-sized masks (size 0 or 1) to complete the resuscitation kits. Among the 2190 cases with known survival status, 49% died before discharge, and among 1035 cases with better data quality, 29% died. The odds of surviving birth asphyxia after resuscitation increased eightfold compared to newborns not resuscitated. Other predictors for survival were the availability of a newborn corner, born at term or post-term, normal birth weight (≥2500 g) and delivered by cesarean or assisted vaginal delivery. Conclusion The survival status of newborns with birth asphyxia was low, particularly in the primary care facilities that lacked the required resuscitation pack. Newborns born in a facility with better data quality were more likely to survive than those born in facilities with poor data quality. Equipping health centers/clinics with resuscitation packs and reducing the incidence of preterm and low birth weight babies should improve survival rates.

Preparedness for neonatal emergencies at birth and associated factors among healthcare providers working at hospitals in northwest Ethiopia: A multi-center cross-sectional study

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Neonatal sepsis and mortality in low-income and middle-income countries from a facility-based birth cohort: an international multisite prospective observational study

“…14 , 29 This finding signals a need for improvement in rapid diagnostic methods and targeted treatment. 31 A recent review has highlighted the use and importance of multi-omics to improve the accuracy of sepsis biomarkers and the use of health systems data for tailoring digital diagnostics. 32 Basic interventions such as targeted infection prevention control and implementation of water, sanitation, and hygiene measures (known as WASH), 33 which contribute to the prevention of spread of antimicrobial resistance, and therefore reduce the incidence of neonatal sepsis.…”

Survival and predictors of asphyxia among neonates admitted in neonatal intensive care units of public hospitals of Addis Ababa, Ethiopia, 2021: a retrospective follow-up study

“…Perinatal asphyxia is multifactorial, including: Obstetric risk factors like: maternal age, antenatal care, maternal comorbidities, primiparity, having maternal fever, prolonged 2 nd stage of labor, and rupture of membrane, place of delivery [ 12 – 14 ]. Likewise neonatal related predictors for survival of asphyxia were sex, prematurity, low birth weight, delay presentation [ 15 – 17 ]. Depressed clinical status at admission, low 5 th min APGAR score, occurrences of infection and seizure within first day, hypothermia, hypoglycemia, hypoxemia, stage II and III of HIE, acute kidney injury, thrombocytopenia, [ 13 , 18 ], were found to decrease the survival of asphyxiated babies significantly.…”