The Profile, Health Seeking Behavior, Referral Patterns, and Outcome of Outborn Neonates Admitted to a District and Regional Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

Abstract

Neonatal mortality is the major contributor to under-five mortality rates in many low and middle income countries. We examined the health practices, care-seeking behavior, and referral of sick outborn neonates to a district and regional hospital in the Upper West Region of Ghana. The study was a cross-sectional study conducted over an eight (8) month period in 2018. Data were obtained from caregiver interviews and case notes. Altogether, 153 outborn neonates were examined. Inappropriate practices including the use of enemas, cord care with cow dung, and herbal baths were found. Three babies treated this way died. The majority of caregivers sought care at a health facility. However, 67 (44%) sought care only after their babies were ill for ≥7 days, suggesting the influence of a period of confinement on health seeking. More than half, 94 (61.4%), of the facilities visited referred patients to destination hospitals without giving any treatment. Delayed care-seeking was associated with a low birth weight, using home remedies, and a maternal age of ≥30 years. Altogether, 12 neonates (7.8%) died, consisting of three males and nine females (p = 0.018). Socio-cultural factors strongly influence health seeking behavior and the health outcome of neonates in this setting. There appeared to be a limited repertoire of interventions for treating neonatal disease in primary care.

The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

“…Thus finding greater mortality among females may be related to differences in care seeking behaviour for the sexes but this must be interpreted with caution given the limited numbers of patients. Other details on sex differences and socio-cultural practices in the neonatal experience of these patients have been presented elsewhere [47].…”

“…Local and international standards have also been developed to improve neonatal care and transport [5,55,56]. However, these improvements must occur concurrently with health system strengthening of receiving facilities to make a significant impact [10,47,57].…”

The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study

“…Apart from the severity of the neonatal conditions themselves, health service factors affecting the smooth running of the neonatal units might also have militated against neonatal survival. These include shortages of materials, lack of a paediatrician, power outages barring electricity supply to the incubators which necessitated the purchase of energy storage devices and deficiencies in the quality of inter-facility transport and primary care, among others [45,46,47]. Reducing these factors require interventions within and beyond the health sector and must include multi-sectoral actions and political will tied with economic development.…”

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“…Altogether, 5 scientific papers involving 1 resident, 4 house officers and 1 medical officer have been published. [15][16][17][18][19] There are 2 other manuscripts, one by a resident and another with a house officer waiting for posting, near publication, among others at different stages of development. Five papers have also been presented at meetings, national and international conferences including two by the residents and one by a house officer.…”