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Blanks KJH, Musaba MW, Ren L, Burgoine K, Mukunya D, Clarke A, Williams S, Gebremichael T, Waiswa P, Darmstadt GL. Neonatal emollient therapy and massage practices in Africa: a scoping review. Int Health 2024; 16:152-164. [PMID: 37480339 PMCID: PMC10911534 DOI: 10.1093/inthealth/ihad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/09/2023] [Accepted: 06/23/2023] [Indexed: 07/24/2023] Open
Abstract
There have been few reports from Africa on the use and health effects of emollient therapy for newborn infants. We aimed to describe neonatal skin care practices in Africa, and to illuminate opportunities to introduce evidence-based interventions to improve these practices. We conducted a scoping review of the quantitative and qualitative published peer-reviewed and grey literature in English on emollient use in Africa. Outcomes of interest included neonatal skin care practices, with a focus on the application of oils and other products to infant skin, including in association with bathing and massage. We screened 5257 articles and summarised findings from 23 studies-13 qualitative, nine quantitative and one mixed methods-that met our study criteria. Seven studies reported the use of emollients for perceived benefits, including thermal care, treatment for illness, promotion of growth and development, infection reduction, skin condition improvement, spirituality and lubrication to aid massage. Four studies reported the quantitative health impact of skin care product applications, including improvements in skin condition, neurodevelopment and bone growth, as well as a reduction in nosocomial infections. This review highlights opportunities for skin care intervention and future research on neonatal skin care practices in Africa.
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Affiliation(s)
| | - Milton W Musaba
- Department of Obstetrics and Gynaecology, Busitema University Faculty of Health Sciences, Pallisa, Mbale, PO Box 1460, Uganda
| | - Lily Ren
- Lane Medical Library, Stanford Medicine, Stanford University, 300 Pasteur Drive, L109, Stanford, CA 94305, USA
| | - Kathy Burgoine
- Mbale Clinical Research Institute, Plot 29, 33 Pallisa, Mbale, Uganda
| | - David Mukunya
- Busitema University Faculty of Health Sciences, Pallisa, Mbale, PO Box 1460, Uganda
- Sanyu Africa Research Institute, Mbale, PO Box 2190, Uganda
| | - Andrew Clarke
- Global Programs, Save the Children UK, 1 St John's Lane, London EC1M 4AR, UK
| | - Sarah Williams
- Global Programs, Save the Children UK, 1 St John's Lane, London EC1M 4AR, UK
| | | | - Peter Waiswa
- Makerere University School of Public Health, College of Health Sciences, Plot 1 New Mulago Hospital Complex, Kampala, Uganda
| | - Gary L Darmstadt
- Prematurity Research Center, Department of Pediatrics, Stanford University School of Medicine, 1701 Page Mill Road, Palo Alto, CA 94304, USA
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Tette EMA, Nartey ET, Nyarko MY, Aduful AK, Neizer ML. Trends in Neonatal Mortality at Princess Marie Louise Children's Hospital, Accra, and the Newborn Strategic Plan: Implications for Reducing Mortality in Hospital and the Community. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1755. [PMID: 38002846 PMCID: PMC10670549 DOI: 10.3390/children10111755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND In low and middle-income countries, close to half of the mortality in children under the age of five years occurs in neonates. OBJECTIVES We examined the trend, medical conditions and factors associated with newborn deaths at the Princess Marie Louise Children's Hospital (PML), Accra, from 2014 to 2017 (4 years). METHODS The study was a cross-sectional study. Data on age, sex, date of admission, date of discharge, cause of death and place of residence of these babies were obtained from the records department. This was transferred into an Access database and analyzed. Components of the Newborn Strategic Plan implemented at the hospital were described. RESULTS Neonatal sepsis, pneumonia and kernicterus were the major causes of death. Admissions increased and 5.4% of the neonates died, declining from 6.5% in 2014 to 4.2% in 2017 due to deliberate actions to reduce neonatal death. The highest mortality occurred in babies residing in an area more than 1 hour's drive away from the hospital. CONCLUSION Implementing the Newborn Strategic Plan was associated with a drop in mortality. A preponderance of community-acquired infections was observed. Thus, locality-specific interventions targeted at known determinants and implementing the newborn strategic plan are essential for reducing neonatal mortality.
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Affiliation(s)
- Edem M. A. Tette
- Department of Community Health, University of Ghana Medical School, Accra P.O. Box 4236, Ghana
- Princess Marie Louise Children’s Hospital, Accra P.O. Box GP 122, Ghana; (M.Y.N.); (M.L.N.)
| | - Edmund T. Nartey
- Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, Accra P.O. Box 4236, Ghana;
| | - Mame Yaa Nyarko
- Princess Marie Louise Children’s Hospital, Accra P.O. Box GP 122, Ghana; (M.Y.N.); (M.L.N.)
| | - Abena K. Aduful
- Family Medicine Department, Korle-Bu Teaching Hospital, Accra P.O. Box GP 4236, Ghana;
| | - Margaret L. Neizer
- Princess Marie Louise Children’s Hospital, Accra P.O. Box GP 122, Ghana; (M.Y.N.); (M.L.N.)
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Ahinkorah BO, Seidu AA, Hagan JE, Budu E, Mohammed A, Adu C, Ameyaw EK, Adoboi F, Schack T. Barriers to healthcare access and healthcare seeking for childhood illnesses among childbearing women in Burundi. PLoS One 2022; 17:e0274547. [PMID: 36178926 PMCID: PMC9524664 DOI: 10.1371/journal.pone.0274547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/30/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction
Poor health seeking behaviour continues to be major challenge in accessing healthcare in sub-Saharan Africa despite the availability of effective treatment for most childhood illnesses. The current study investigated the barriers to healthcare access and health seeking for childhood illnesses in Burundi.
Methods
The study utilized data from the 2016–17 Burundi Demographic and Health Survey (BDHS). A total of 2173 children under five of childbearing women were included in our study. The outcome variable for the study was healthcare seeking for childhood illnesses (diarrhea and fever/cough). Barriers to healthcare access were the explanatory variables and maternal and child factors were the control variables. Chi-square test of independence and a binary logistic regression modelling were carried out to generate the results.
Results
Overall, less than 50% of children in Burundi who were ill two weeks before the survey obtained healthcare. We found that children of mothers who perceived getting money for medical care for self as a big problem [aOR = 0.75; CI = 0.60–0.93] and considered going for medical care alone as a big problem [aOR = 0.71; CI = 0.55–0.91] had lower odds of getting healthcare, compared to those of mothers who considered these indicators as not a big problem. The results also showed that children of mothers who had three [aOR = 1.48; 1.02–2.15] and four [aOR = 1.62; 1.10–2.39], children were more likely to get healthcare for childhood illnesses compared to those whose mothers had one child. Children of mothers with single birth children were less likely to get healthcare compared to those whose mothers had multiple births.
Conclusion
Findings of the low prevalence of healthcare for childhood illnesses in Burundi suggest the need for government and non-governmental health organizations to strengthen women’s healthcare accessibility for child healthcare services and health seeking behaviours. The Burundian government through multi-sectoral partnership should strengthen health systems for maternal health and address structural determinants of women’s health by creating favourable conditions to improve the status of women and foster their overall socioeconomic well-being. Free child healthcare policies in Burundi should be strengthened to enhance the utilization of child healthcare services in Burundi.
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Affiliation(s)
- Bright Opoku Ahinkorah
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, Australia
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - John Elvis Hagan
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
- Faculty of Psychology and Sport Sciences, Neurocognition and Action-Biomechanics-Research Group, Bielefeld University, Bielefeld, Germany
- * E-mail:
| | - Eugene Budu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Aliu Mohammed
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
| | - Collins Adu
- Department of Health Promotion and Disability Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Kwabena Ameyaw
- Faculty of Health, School of Public Health, University of Technology Sydney, Ultimo, Australia
| | - Faustina Adoboi
- Cape Coast Nursing and Midwifery Training College, Cape Coast, Ghana
| | - Thomas Schack
- Department of Health, Physical Education, and Recreation, University of Cape Coast, Cape Coast, Ghana
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Tette EMA, Gyan BA, Koram KA. Perspectives on Research Internships for Medical Students and Young Doctors in Ghana: An Opportunity to Replenish the Stock of Physician Investigators? ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:473-478. [PMID: 32753996 PMCID: PMC7354947 DOI: 10.2147/amep.s243719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 06/01/2020] [Indexed: 06/11/2023]
Abstract
The corona virus pandemic undoubtedly demonstrates the growing need for research in medical science. However, with the decline in physician scientists world-wide, innovative ways are needed to engender interest in research among medical students and young doctors to replenish the stock of physician investigators. One way of doing this is to create compulsory and elective projects for them. We describe research internships created for medical students at the Noguchi Memorial Institute for Medical Research to expose them to the rudiments of biomedical research and proposal development. We also describe research internships for doctors waiting for house job postings or keen to do research who needed mentorship. Though the response has been positive, the full impact will be realized with time. The recognition that training should be backed with a supportive environment, mentorship and clear career paths for physician scientists is also mentioned.
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Affiliation(s)
- Edem M A Tette
- Department of Community Health, University of Ghana Medical School, Accra, Greater Accra Region, Ghana
| | - Ben A Gyan
- Department of Immunology, Noguchi Memorial Institute for Medical Research University of Ghana, Accra, Greater Accra Region, Ghana
| | - Kwadwo A Koram
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research University of Ghana, Accra, Greater Accra Region, Ghana
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Tette EMA, Nartey ET, Nuertey BD, Azusong EA, Akaateba D, Yirifere J, Alandu A, Seneadza NAH, Gandau NB, Renner LA. The pattern of neonatal admissions and mortality at a regional and district hospital in the Upper West Region of Ghana; a cross sectional study. PLoS One 2020; 15:e0232406. [PMID: 32365073 PMCID: PMC7197810 DOI: 10.1371/journal.pone.0232406] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/14/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND High global neonatal deaths have triggered efforts to improve facility-based care. However, the outcomes achievable at different levels of care are unclear. This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality. OBJECTIVE This study compared morbidity and mortality patterns of newborns admitted to a regional and a district hospital in Ghana to determine outcome, risk and modifiable factors associated with mortality. METHODS A cross-sectional study involving a records-review over one year at the Upper West Regional Hospital, and three years at St Joseph's District Hospital, Jirapa was carried out. Age, sex, gestational age, weight, duration of admission, diagnosis, among others were examined. The data were analysed and statistical inference made. RESULTS Altogether, 2004 newborns were examined, comprising 1,241(62%) from St Joseph's District Hospital and 763(38%) from Upper West Regional Hospital. The proportion of neonatal deaths was similar, 8.94% (St Joseph's District Hospital) and 8.91% (Upper West Regional Hospital). Prematurity, neonatal sepsis, birth asphyxia, low birth weight, neonatal jaundice and pneumonia contributed the most to mortality and suspected infections including malaria accounted for almost half (45.5%). Mortality was significantly associated with duration of stay of 48 hours, being premature, and being younger than 3 days. CONCLUSION Majority of the mortality among the neonates admitted was due to preventable causes. Better stabilization and further studies on the epidemiology of sepsis, prematurity, low birth weight, including the contribution of malaria to these and outcome of transferred neonates are needed.
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Affiliation(s)
- Edem M. A. Tette
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Edmund T. Nartey
- Centre for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, Accra, Ghana
| | - Benjamin D. Nuertey
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
- Public Health Department, Tamale Teaching Hospital, Tamale, Ghana
| | | | | | | | | | | | - Naa Barnabas Gandau
- Upper West Regional Hospital, Wa, Ghana
- School of Medical Sciences, University for Development Studies, Tamale, Ghana
| | - Lorna A. Renner
- Department of Child Health, University of Ghana Medical School, Accra, Ghana
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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. CHILDREN-BASEL 2020; 7:children7030022. [PMID: 32244943 PMCID: PMC7140801 DOI: 10.3390/children7030022] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 11/17/2022]
Abstract
Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted.
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