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Ali IA, Inchon P, Suwannaporn S, Achalapong J. Neonatal mortality and associated factors among newborns in Mogadishu, Somalia: a multicenter hospital-based cross-sectional study. BMC Public Health 2024; 24:1635. [PMID: 38898456 PMCID: PMC11186222 DOI: 10.1186/s12889-024-19149-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
INTRODUCTION Neonatal mortality is a significant public health problem in Sub-Saharan Africa, particularly in Somalia, where limited data exists about this. Mogadishu, the densely populated capital, faces a high rate of neonatal mortality, but this has not been widely studied on a national level. Healthcare providers and policymakers are working to reduce newborn deaths, but a comprehensive understanding of the contributing factors is crucial for effective strategies. Therefore, this study aims to determine the magnitude of neonatal death and identify factors associated with it in Mogadishu, Somalia. METHOD A multicenter hospital-based cross-sectional study was conducted to collect data from participants at 5 purposively selected hospitals in Mogadishu, Somalia. A well-structured, reliable, self-developed, validated questionnaire containing socio-demographic, maternal, and neonatal characteristics was used as a research tool. Descriptive statistics were used for categorical and continuous variables presented. Chi-square and logistic regression were used to identify factors associated with neonatal mortality at a significant level of α = 0.05. RESULTS A total of 513 participants were recruited for the study. The prevalence of neonatal mortality was 26.5% [95%CI = 22.6-30.2]. In a multivariable model, 9 variables were found: female newborns (AOR = 1.98, 95%CI = 1.22-3.19), those their mothers who did not attend ANC visits (AOR = 2.59, 95%CI = 1.05-6.45), those their mothers who did not take tetanus toxoid vaccination (AOR = 1.82, 95%CI = 1.01-3.28), those their mothers who delivered in instrumental assistant mode (AOR = 3.01, 95%CI = 1.38-6.56), those who had neonatal sepsis (AOR = 2.24, (95%CI = 1.26-3.98), neonatal tetanus (AOR = 16.03, 95%CI = 3.69-69.49), and pneumonia (AOR = 4.06, 95%CI = 1.60-10.31) diseases during hospitalization, premature (AOR = 1.99, 95%CI = 1.00-3.94) and postmature (AOR = 4.82, 95%CI = 1.64-14.16) neonates, those with a birth weight of less than 2500 gr (AOR = 4.82, 95%CI = 2.34-9.95), those who needed resuscitation after delivery (AOR = 2.78, 95%CI = 1.51-5.13), and those who did not initiate early breastfeeding (AOR = 2.28, 95%CI = 1.12-4.66), were significantly associated with neonatal mortality compared to their counterparts. CONCLUSION In this study, neonatal mortality was high prevalence. Therefore, the intervention efforts should focus on strategies to reduce maternal and neonatal factors related to neonatal mortality. Healthcare workers and health institutions should provide appropriate antenatal, postnatal, and newborn care.
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Affiliation(s)
- Ikran Abdulkadir Ali
- Department of Public Health, School of Health Science, Mae Fah Luang University, Chiang Rai Province, Thailand
- Department of Neonatal Intensive Care Unit, Yardimeli Hospital, Mogadishu, Somalia
| | - Pamornsri Inchon
- Department of Public Health, School of Health Science, Mae Fah Luang University, Chiang Rai Province, Thailand.
| | - Sirinan Suwannaporn
- Department of Public Health, School of Health Science, Mae Fah Luang University, Chiang Rai Province, Thailand
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Tawiah K, Asosega KA, Iddi S, Opoku AA, Abdul IW, Ansah RK, Bukari FK, Okyere E, Adebanji AO. Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana. Health Serv Insights 2024; 17:11786329241258836. [PMID: 38873401 PMCID: PMC11171432 DOI: 10.1177/11786329241258836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 05/16/2024] [Indexed: 06/15/2024] Open
Abstract
Objectives Ghana's quest to reduce neonatal mortality, in hospital facilities and communities, continues to be a nightmare. The pursuit of achieving healthy lives and well-being for neonates as enshrined in Sustainable Development Goal three lingered in challenging hospital facilities and communities. Notwithstanding that, there have been increasing efforts in that direction. This study examines the contributing factors that hinder the fight against neonatal mortality in all hospital facilities in the Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana. Methods The study utilized neonatal mortality data consisting of neonatal deaths, structural facility related variables, medical human resources, types of hospital facilities and natal care. The data was collected longitudinally from 2014 to 2019. These variables were analysed using the negative binomial hurdle regression (NBH) model to determine factors that contribute to this menace at the facility level. Cause-specific deaths were obtained to determine the leading causes of neonatal deaths within health facilities in the two municipal assemblies. Results The study established that the leading causes of neonatal mortality in these districts are birth asphyxia (46%), premature birth (33%), neonatal sepsis (11%) and neonatal jaundice (7%). The NBH showed that neonatal mortality in hospital facilities depend on the number of incubators, monitoring equipment, hand washing facilities, CPAPb machines, radiant warmers, physiotherapy machines, midwives, paediatric doctors and paediatric nurses in the hospital facility. Conclusions Early management of neonatal sepsis, birth asphyxia, premature birth and neonatal infections is required to reduce neonatal deaths. The government and all stakeholders in the health sector should provide all hospital facilities with the essential equipment and the medical human resources necessary to eradicate the menace. This will make the realization of Sustainable Development Goal three, which calls for healthy lives and well-being for all, a reality.
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Affiliation(s)
- Kassim Tawiah
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
- Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Killian Asampana Asosega
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
- Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Iddi
- Department of Statistics and Actuarial Science, University of Ghana, Accra, Ghana
| | - Alex Akwasi Opoku
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
| | - Iddrisu Wahab Abdul
- Department of Mathematics and Statistics, Ghana Communication Technology University, Accra, Ghana
| | - Richard Kwame Ansah
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
- Department of Mathematics, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Francis Kwame Bukari
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
- Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eric Okyere
- Department of Mathematics and Statistics, University of Energy and Natural Resources, Sunyani, Ghana
| | - Atinuke Olusola Adebanji
- Department of Statistics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Apanga DA, Kumbeni MT, Salifu AM, Mireku-Gyimah N, Apanga PA. Predictors of neonatal mortality in the Eastern Regional Hospital in Ghana: A retrospective cohort study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003295. [PMID: 38843308 PMCID: PMC11156434 DOI: 10.1371/journal.pgph.0003295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 05/08/2024] [Indexed: 06/10/2024]
Abstract
Neonatal mortality accounts for nearly half of under-5 mortality in Ghana. The aim of this study was to identify the predictors of neonatal mortality in the Eastern Regional Hospital, Ghana. This was a retrospective cohort study conducted using secondary data from electronic medical records from the Eastern Regional Hospital between 1st January 2022 and 31st December 2022. The Kaplan-Meier estimator and adjusted Cox regression model were used to estimate survival probability and to assess the predictors of neonatal mortality. Data on 1684 neonates were analyzed and we found that 11.82% deaths occurred with a neonatal mortality rate (NMR) of 13.98 (95% CI: 12.05, 15.91) per 1000 person-days. Most neonatal deaths occurred within the first 24hrs of life (9.9%). The predictors of neonatal mortality were found to be low birthweight [Adjusted hazard rate (aHR): 1.63, 95% CI: 1.04, 2.54], hypothermia (aHR: 1.82, 95% CI: 1.16, 2.85), hyperthermia (aHR: 1.85, 95% CI: 1.01, 3.39), birth asphyxia (aHR: 3.69, 95% CI: 1.68, 8.11), and multiparty (aHR: 1.66, 95% CI: 1.02, 2.70). However, neonates aged 8-28 days (aHR: 0.41, 95% CI: 0.21, 0.81), born in the Eastern Regional Hospital (aHR: 0.39, 95% CI: 0.28, 0.55), walk-in neonates (aHR: 0.54, 95% CI: 0.32, 0.90), and neonates whose mothers had 8 or more antenatal contacts (aHR: 0.54, 95% CI: 0.32, 0.92) had lower neonatal mortality. There was high NMR in the Eastern Regional Hospital in Ghana. Averting complications such as low birthweight, hypothermia, hyperthermia, birth asphyxia, including the provision of obstetric and early neonatal care within the first 24 hours of life is critical to reducing neonatal mortality. Adherence to the World Health Organization's recommendation of 8 or more antenatal contacts among pregnant women is also essential in reducing neonatal mortality.
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Affiliation(s)
| | - Maxwell Tii Kumbeni
- School of Public Health and Nutrition, College of Health, Oregon State University, Corvallis, Oregon, United States of America
| | | | | | - Paschal Awingura Apanga
- Nuffield Department of Medicine, Jenner Institute, University of Oxford, Oxford, United Kingdom
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Adams YJ, Miller ML, Agbenyo JS, Ehla EE, Clinton GA. Postpartum care needs assessment: women's understanding of postpartum care, practices, barriers, and educational needs. BMC Pregnancy Childbirth 2023; 23:502. [PMID: 37420215 DOI: 10.1186/s12884-023-05813-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 06/25/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND Complications in the postpartum period pose substantial risks to women and can result in significant maternal morbidity and mortality. However, there is much less attention on postpartum care compared to pregnancy and childbirth. The goal of this study was to gather information on women's knowledge of postpartum care and complications, recovery practices after childbirth, perceived barriers to receiving care during the postpartum period, and educational needs in four health centers. The findings can inform the development of appropriate curriculum and interventions for postnatal care education in similar settings. METHODS A descriptive qualitative study design was employed. Eight focus group discussions were conducted among 54 postpartum women who delivered in four health centers in Sagnarigu District in Tamale, Ghana. Audio recordings of focus group data were transcribed and translated, and thematic analysis was conducted. RESULTS There were six main themes that emerged from the focus group discussions: 1) baby focused postpartum care; 2) postpartum practices; 3) inadequate knowledge ofpostpartum danger signs; 4) barriers to accessing postpartum care 5) experiences of poor mental health; and 6) need for postpartum education. CONCLUSIONS Postpartum care for women in this study was primarily perceived as care of the baby post-delivery and missing key information on physical and mental health care for the mother. This can result in poor adjustment postpartum and critically, a lack of knowledge on danger signs for common causes of morbidity and mortality in the postpartum period. Future research needs to understand how to communicate important information on postpartum mental and physical health to better protect mothers in the region.
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Obeng C, Jackson F, Amissah-Essel S, Nsiah-Asamoah C, Perry CA, Gonzalez Casanova I, Obeng-Gyasi E. Women's perspectives on human milk banking in Ghana: results from a cross-sectional study. Front Public Health 2023; 11:1128375. [PMID: 37304082 PMCID: PMC10248423 DOI: 10.3389/fpubh.2023.1128375] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Background Although political and academic interest exists in Ghana to include human milk banks (HMB) into current maternal and child health programs, efforts to establish a HMB have not yet been subjected to any real empirical inspection with the view toward implementation. Furthermore, views toward the establishment of a HMB in Ghana have not been assessed among Ghanaian women. The aims of the current study were to examine Ghanaian women's views about HMB, and to investigate women's willingness to donate to a HMB. Methods Quantitative and qualitative responses were received from Ghanaian females (n = 1,270) aged 18+ years. Excluding outliers and missing data (n = 321), a final sample of 949 was retained for final analysis. Chi-square tests and logistic regression analysis were computed on quantitative data; Thematic analysis was performed on the qualitative responses. Results In our sample, 64.7% of respondents indicated that Ghana is ready for a HMB. The majority (77.2%) were willing to donate milk, and 69.4% believed that donating to the HMB would favor their child. The main concerns for the unwillingness to donate excess milk included: (i) the idea of HMBs as strange/bizarre (n = 47), (ii) fear of infections (n = 15), (iii) religious beliefs (n = 9), and (iv) insufficient information (n = 24). This study serves as the first step toward the development of a HMB in Ghana. Conclusions Overall, Ghanaian women support the building of a HMB to enhance infant nutrition and reduce childhood morbidity and mortality.
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Affiliation(s)
- Cecilia Obeng
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Frederica Jackson
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Salome Amissah-Essel
- Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
| | | | - Cydne A. Perry
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Ines Gonzalez Casanova
- Department of Applied Health Science, School of Public Heath, Indiana University, Bloomington, IN, United States
| | - Emmanuel Obeng-Gyasi
- Department of Built Environment, North Carolina Agricultural and Technical State University, Greensboro, NC, Canada
- Environmental Health and Disease Laboratory, North Carolina Agricultural and Technical State University, Greensboro, NC, Canada
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Tuglo LS, Agyekum BA, Darku ED, Alida NM, Seelo KP, Magaga K, Chiambiro KV, Tuglo JD, Sakre SM, Otoo DD, Gmanyami JM. Sociodemographic characteristics and reproductive health factors associated with maternal knowledge and practice of infection prevention in neonates in North Dayi District, Ghana. Front Public Health 2023; 11:1062268. [PMID: 37139360 PMCID: PMC10149744 DOI: 10.3389/fpubh.2023.1062268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 03/28/2023] [Indexed: 05/05/2023] Open
Abstract
Background Neonates are at a greater risk of infection, but data on the maternal knowledge and practice of infection prevention in neonates (IPNs) are scarce. This study aimed to assess sociodemographic characteristics and reproductive health factors associated with maternal knowledge and practice of IPNs in North Dayi District, Ghana. Methods This was a multicenter cross-sectional study conducted among 612 mothers. A structured questionnaire was used for data collection adapted from previous studies and the IPN guidelines of the World Health Organization (WHO). Bivariable analyses were performed to determine the association between maternal knowledge and practice of IPNs and sociodemographic characteristics and reproductive health factors. Results Analysis showed that less than one-fifth of the mothers (12.9%) had poor knowledge of IPNs, while 21.6% incorrectly practiced it. Mothers who had poor knowledge of IPNs [adjusted odds ratio (AOR) = 13.33 (95% CI: 7.69-23.26), p < 0.001] were more likely to have a poor practice of IPNs. Conclusion About one-fifth of the mothers in this study had poor knowledge or poor practice of IPNs according to the WHO's guidelines. The Health Directorate of North Dayi District should explore the risk factors associated with poor IPNs and increase successful guideline adherence with intensified educational outreach and campaigns.
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Affiliation(s)
- Lawrence Sena Tuglo
- Department of Nutrition and Dietetics, School of Allied Health Sciences, University of Health and Allied Sciences, Ho, Ghana
- *Correspondence: Lawrence Sena Tuglo,
| | - Benjamin Adu Agyekum
- Department of Dentistry and Surgery, School of Medicine, Nantong University, Nantong, China
| | - Edward Delali Darku
- Department of Clinical Medicine, School of Medicine, Fujian Medical University, Fuzhou, China
| | - Natabou Morine Alida
- Department of Pharmaceutics, School of Pharmacy, Nantong University, Nantong, China
| | - Kitso Palesa Seelo
- Department of Dentistry and Surgery, School of Medicine, Nantong University, Nantong, China
| | - Khauhelo Magaga
- Department of Dentistry and Surgery, School of Medicine, Nantong University, Nantong, China
| | | | - Jessica Dzigbordi Tuglo
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | - Desmond Dzidzornu Otoo
- Department of Public Administration and Health Services Management, School of Business, University of Ghana, Accra, Ghana
| | - Jonathan Mawutor Gmanyami
- Global Health and Infectious Diseases Group, Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
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Tetteh FKM, Fatchu R, Ackah K, Philips TJ, Shewade HD, Fenny AP, Timire C, Edwards JK, Parbie EA. Sepsis among Neonates in a Ghanaian Tertiary Military Hospital: Culture Results and Turnaround Times. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11659. [PMID: 36141932 PMCID: PMC9517560 DOI: 10.3390/ijerph191811659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/17/2022] [Accepted: 08/20/2022] [Indexed: 06/16/2023]
Abstract
In this study, we described the bacterial profile, antibiotic resistance pattern, and laboratory result turnaround time (TAT) in neonates with suspected sepsis from a tertiary-level, military hospital in Accra, Ghana (2017-2020). This was a cross-sectional study using secondary data from electronic medical records. Of 471 neonates clinically diagnosed with suspected sepsis in whom blood samples were collected, the median TAT from culture request to report was three days for neonates who were culture-positive and five days for neonates who were culture-negative. There were 241 (51%) neonates discharged before the receipt of culture reports, and of them, 37 (15%) were culture-positive. Of 471 neonates, twenty-nine percent (n = 139) were bacteriologically confirmed, of whom 61% (n = 85) had late-onset sepsis. Gram-positive bacterial infection (89%, n = 124) was the most common cause of culture-positive neonatal sepsis. The most frequent Gram-positive pathogen was coagulase-negative Staphylococcus (55%, n = 68) followed by Staphylococcus aureus (36%, n = 45), of which one in two were multidrug resistant. The reasons for large numbers being discharged before the receipt of culture reports need to be further explored. There is a need for improved infection prevention and control, along with ongoing local antimicrobial resistance surveillance and antibiotic stewardship to guide future empirical treatment.
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Affiliation(s)
| | - Raymond Fatchu
- Pathology Division, 37 Military Hospital, Neghelli Barracks, Accra GA 01, Ghana
| | - Kingsley Ackah
- Pathology Division, 37 Military Hospital, Neghelli Barracks, Accra GA 01, Ghana
| | - Trudy Janice Philips
- Clinical Pathology Department, Noguchi Memorial Institute for Medical Research, P.O. Box LG 581, Accra GA 01, Ghana
| | - Hemant Deepak Shewade
- Division of Health System Research, ICMR-National Institute of Epidemiology (ICMR-NIE), Chennai 600077, India
| | - Ama Pokuaa Fenny
- Institute of Statistical, Social and Economic Research, University of Ghana, P.O. Box LG 1181, Accra GA 01, Ghana
| | - Collins Timire
- International Union against Tuberculosis and Lung Disease (The Union), 75006 Paris, France
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