Improving the quality of neonatal data capture and clinical care at a tertiary-care hospital in Uganda through enhanced surveillance, training and mentorship.
Paediatr Int Child Health
; 40(2): 92-104, 2020 05.
Article
em En
| MEDLINE
| ID: mdl-31290375
ABSTRACT
Introduction:
Accurate documentation of neonatal morbidity and mortality is limited in many countries in sub-Saharan Africa. This project aimed to establish a surveillance system for neonatal conditions as an approach to improving the quality of neonatal care.Methods:
A systematic data capture and surveillance system was established at Jinja Regional Referral Hospital, Uganda using a standardised neonatal medical record form which collected detailed individual patient level data. Additionally, training and mentorship were conducted and basic equipment was provided.Results:
A total of 4178 neonates were hospitalised from July 2014 to December 2016. Median (IQR) age on admission was one day (1-3) and 48.0% (1851/3859) were male. Median (IQR) duration of hospitalisation was 17 days (IQR 10-40) and the longest duration of hospitalisation was 47 days (IQR 41-58). The majority were referrals from government health facilities (54.4%, 2012/3699), though 30.6% (1123/3669) presented as self-referrals. Septicaemia (44.9%, 1962/4371), prematurity (21.0%, 917/4371) and birth asphyxia (19.1%, 833/4371) were the most common diagnoses. The overall mortality was 13.8% (577/4178) and the commonest causes of death included septicaemia (26.9%, 155/577), prematurity (24.3%, 140/577), birth asphyxia (21.0%, 121/577), hypothermia (9.9%, 57/577) and respiratory distress (8.0%, 46/577). The majority of deaths (51.5%, 297/577) occurred within the first 24 h of hospitalisation although a significant proportion of deaths also occurred after 7 days of hospitalisation (24.1%, 139/577). A modest decrease in mortality and improvement in clinical outcome were observed.Conclusion:
Improvement in neonatal data capture and quality of care was observed following establishment of an enhanced surveillance system, training and mentorship.Abbreviations aOR adjusted odds ratio; CHRP Centre for Health research and Programmes; HC health centre; HMIS Health Management Information System; JRRH Jinja Regional Referral Hospital; NMRF neonatal medical record form; PMTCT prevention of mother-to-child transmission of HIV; UPA Uganda Paediatric Association.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Mentores
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Melhoria de Qualidade
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Centros de Atenção Terciária
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Cuidado do Lactente
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article