Neonatal mortality contributors using the three delays audit: a study from Albuluk paediatrics teaching hospital in Sudan

Authors

  • Fikria Abdalwhab Salih Department of Paediatrics, Omdurman Islamic University, Omdurman, Sudan
  • Ebtihal Elameen Eltyeb Department of Paediatrics, Jazan University of Medicine, Jazan, KSA

DOI:

https://doi.org/10.18203/2320-6012.ijrms20175129

Keywords:

Audit, Contributors, Neonatal mortality, Three delays

Abstract

 

Background: In certain developing countries neonatal mortality rates still showed a slower decline. Many factors were attributed to neonatal mortality that varies from one country to another. This study investigated factors attributed to neonatal mortality in Sudan.

Methods: Data was collected from 72 neonatal deaths records at Albuluk pediatrics' teaching hospital, and then it was analyzed using a modified three delays model to determine contributing delays.

Results: 31.9% of neonatal mortality occurred on the first day after birth and 86.1% thereafter. Newborn characteristics showed that more than half of dead newborn were male and more than 80% admitted in the age of more than 2 days although there was 26% of involved newborn were preterm. About two third of deliveries were home deliveries and only 52% of the mothers were in regular antenatal care. The leading causes of death were sepsis and pneumonia in 83% followed by birth asphyxia in 11% of total neonatal mortality. Regarding the three delays audit; delay in decision making were present in 54.2% and that was due to inability of the mothers to recognize danger signs, delay in reaching the health care facility was present in 9.8% of the neonatal mortality, while delay in initiation of treatment in the healthcare facility was present in only 6.9%.

Conclusions: Maternal knowledge of neonatal danger signs and decision to seek medical care is a major contributor for neonatal mortality in this study. Further efforts should be exerting to raise knowledge of the mothers about danger signs of neonatal illness.

References

Lawn JE, Cousens S, Zupan J, Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: when? Where? Why?. Lancet. 2005;365(9462):891-900.

World Health Organization. The World Health Report 2005: Make every mother and child count. World Health Organization; 2005. Available at http://www.who.int/whr/2005/en/.

Jha P, Gajalakshmi V, Gupta PC, Kumar R, Mony P, Dhingra N, et al. Prospective study of one million deaths in India: rationale, design, and validation results. PLoS medicine. 2005;3(2):e18.

Liu L, Johnson HL, Cousens S, Perin J, Scott S, Lawn JE, et al. Global, regional, and national causes of child mortality: an updated systematic analysis for 2010 with time trends since 2000. Lancet. 2012;379(9832):2151-61.

Bashir AO, Ibrahim GH, Bashier IA, Adam I. Neonatal mortality in Sudan: analysis of the Sudan household survey, 2010. BMC Public Health. 2013;13:287.

Khalifa AL, El-Amin EO, Abdelkhair SM, El-Sheikh MA. Overview of maternal and perinatal mortality in Sudan. InSeminars in Fetal and Neonatal Medicine 2015;20(5):321-325.

Ali AA, Adam I. Lack of antenatal care, education, and high maternal mortality in Kassala hospital, eastern Sudan during 2005–2009. J Mater-Fetal Neo Medic. 2011;24(8):1077-8.

Thadeus S, Maine D. Too far to walk: maternal mortality in context. Soc Sci Med. 1994;38:1091-1110.

UNFPA. Maternal mortality reduction program in Rwanda. Available at http://rwanda.unfpa.org/drive/ MaternalMortalityReductioninRwanda%28VLR%29.pdf. Accessed 12 June2012.

USAID. MCH program description: Rwanda July2008. Available at http://pdf.usaid.gov/pdf_docs /PDACP019.pdf. Accessed 13 June 2012.

Padmanaban P, Raman PS, Mavalankar DV. Innovations and challenges in reducing maternal mortality in Tamil Nadu, India. J Health Popul Nutr. 2009;27:202-219.

Waiswa P, Kallander K, Peterson S, Tomson G, Pariyo GW. Using the three delays model to understand why newborn babies die in eastern Uganda. Trop Medic Inter Heal. 2010;15(8):964-72.

R. P. Upadhyay et al. Using Three Delays Model to Understand the Social Factors responsible for Neonatal Deaths in Rural Haryana, India. J Tropic Pediatr. 2013, 59 (5): 100-105.

Mbaruku G, van Roosmalen J, Kimondo I, Bilango F, Bergström S. Perinatal audit using the 3‐delays model in western Tanzania. Inter J Gynecol Obs. 2009;106(1):85-8.

Jammeh A, Sundby J, Vangen S. Barriers to emergency obstetric care services in perinatal deaths in rural gambia: a qualitative in-depth interview study. ISRN Obstet Gynecol. 2011:981096.

Bazzano AN, Kirkwood BR, Tawiah‐Agyemang C, Owusu‐Agyei S, Adongo PB. Beyond symptom recognition: care‐seeking for ill newborns in rural Ghana. Tropic Medic Inter Heal. 2008;13(1):123-8.

Kibaru EG, Otara AM. Knowledge of neonatal danger signs among mothers attending well baby clinic in Nakuru Central District, Kenya: cross sectional descriptive study. BMC Res Notes. 2016;9(1):481.

Dongre AR, Deshmukh PR, Garg BS. A community based approach to improve health care seeking for newborn danger signs in rural Wardha, India. Ind J Pediatr. 2009;76:45-50.

Rahman A, Leppard M, Rashid S, Jahan N, Nasreen HE. Community perceptions of behaviour change communication interventions of the maternal neonatal and child health programme in rural Bangladesh: an exploratory study. BMC health services research. 2016;16(1):389.

Rahman M, Yunus FM, Shah R, Jhohura FT, Mistry SK, Quayyum T, et al. A controlled before-and-after perspective on the improving maternal, neonatal, and child survival program in rural Bangladesh: an impact analysis. PloS one. 2016;11(9):e0161647.

Boone P, Eble A, Elbourne D, Frost C, Jayanty C, Lakshminarayana R, et al. Community health promotion and medical provision for neonatal health-CHAMPION cluster randomised trial in Nagarkurnool district, Telangana (formerly Andhra Pradesh), India. PLoS Medic. 2017;14(7):e1002324.324

World Health Organization. Child and adolescent health, 2014. Available at http://www.emro.who.int /child-adolescent-health/data-statistics/sudan.html.

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Published

2017-11-25

How to Cite

Abdalwhab Salih, F., & Elameen Eltyeb, E. (2017). Neonatal mortality contributors using the three delays audit: a study from Albuluk paediatrics teaching hospital in Sudan. International Journal of Research in Medical Sciences, 5(12), 5139–5144. https://doi.org/10.18203/2320-6012.ijrms20175129

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Original Research Articles