The Global Network Neonatal Cause of Death algorithm for low‐resource settings

Abstract

Aim This study estimated the causes of neonatal death using an algorithm for low-resource areas, where 98% of the world’s neonatal deaths occur. Methods We enrolled women in India, Pakistan, Guatemala, the Democratic Republic of Congo, Kenya and Zambia from 2014–2016 and tracked their delivery and newborn outcomes for up to 28 days. Antenatal care and delivery symptoms were collected using a structured questionnaire, clinical observation and, or, a physical examination. The Global Network Cause of Death algorithm was used to assign the cause of neonatal death, analysed by country and day of death. Results One third (33.1%) of the 3,068 neonatal deaths were due to suspected infection, 30.8% to prematurity, 21.2% to asphyxia, 9.5% to congenital anomalies and 5.4% did not have a cause of death assigned. Prematurity and asphyxia-related deaths were more common on the first day of life (46.7% and 52.9%, respectively), while most deaths due to infection occurred after the first day of life (86.9%). The distribution of causes was similar to global data reported by other major studies. Conclusions The Global Network algorithm provided a reliable cause of neonatal death in low-resource settings and can be used to inform public health strategies to reduce mortality.

Congenital obstructive bowel anomalies presenting after neonatal age

“…Howbeit, some of our findings might point to some contributory factors like delayed detection or delayed referral or both. Delayed detection may arise from inadequate antenatal care and lack of routine well baby examination which has also been previously reported from some developing countries13,14; or inability of the healthcare personnel at the initial point of contact of the patients to identify and evaluate for these disorders. Published works from some developing countries4,5,7–9,13 have also highlighted the latter reason for delayed detection, indicating that it might contribute to most of the delays in definitive diagnosis and treatment; delayed referral is a consequence of delayed detection.…”

Highlights in this issue

“…In another paper, Garces et al. evaluated the use of the global network neonatal cause of death algorithm in low‐resource settings in six countries and found that it proved to be a reliable tool. Readers may also be interested in the paper by Magnin et al.…”

Enabling change in public health services: Insights from the implementation of nurse mentoring interventions to improve quality of obstetric and newborn care in two North Indian states

“…Improving care in public health services: the case of maternal and newborn care in India While significant gains have been made over the last two decades, India continues to lag behind many LMIC peers (NITI, 2018) in maternal and newborn health. The main causes of maternal and newborn deaths are potentially manageable through well-functioning obstetric services (Garces et al, 2017;Say et al, 2014). In India, poor quality obstetric care in public health facilities and the difficulties in changing health worker behaviour have been widely recognised (Chaturvedi et al, 2015;Das et al, 2012;Das et al, 2015;Sharma et al, 2017).…”