Search results

Around three million infants die within the first four weeks of life each year – nearly all (98%) of these deaths occur in developing countries. Approximately one million newborns die each year in India. Therefore, this study aims to determine the patterns of reported neonatal morbidity and care-seeking behavior and identify factors associated with it.

A cross-sectional study was conducted during November 2016. A systematic random sampling technique was used to select the sample. Statistical techniques like Binary Logistic regression and chi-square test were used.

The results of the study showed that around 31% mothers of neonates reported that their neonates suffered from some kind of morbidity. Fever, jaundice, cough and cold, the low birth-weight and difficulty in breathing were the most common dangers signs reported. Birth order and mother’s knowledge of neonatal danger signs were found to be significantly associated with reporting of neonatal morbidity. In all 95% of the mothers sought care for their newborns. Among those who had problems, 59% consulted private hospitals/clinics, 30% visited District Hospital/Taluka Hospital or higher facilities and another 9% to Primary Health Centers/Community Health Centers. Further, findings show that nearly half of the neonates taken to government facilities have got free treatment, whereas an average cost of 7,156 INR were recorded for treatment, 935 INR for outpatient department and 13,774 INR for inpatient department cases.

There is an urgent need to implement intervention modalities that focus on increasing the level of parental education and access to treatment, and advocating the message regarding newborn danger signs during pregnancy is pinpointed.

The purpose of this paper is to describe Burmese migrant women’s perceptions of health and well-being during pregnancy, their health promoting practices and their experiences with the Thai antenatal services.

The study used an ethnographic design. Observations were conducted in two antenatal clinics in southern Thailand. Ten Burmese migrant women and three Burmese interpreters participated in interviews. Data were analysed using thematic analysis.

The Burmese women wanted to take care of themselves and their baby to the best of their ability. This included following traditional practices and attending the antenatal clinic if able. Negotiating the demands of earning an income, and protecting their unborn baby, sometimes led to unhealthy practices such as consuming energy drinks and herbal tonics to improve performance. Accessing antenatal care was a positive health seeking behaviour noted in this community, however, it was not available to all.

This is a small ethnographic study conducted in one Province in Thailand and all Burmese participants were legal migrants. Further research is required to understand the needs of pregnant women not able to access maternity services because of their status as an illegal migrant.

Community-based health promotion initiatives need to focus on the nutrition of pregnant women who are migrants living in southern Thailand. New models of care may increase migrant women’s use of antenatal services.

Most studies of the health of migrant women are conducted in high-income countries. This study demonstrates the difficulties experienced by women migrating from a low to middle-income country.

Severe bacterial infection is a major cause of neonatal morbidity and mortality worldwide. Geographical-based demographic laboratory and clinical data are required to get a conclusion about the bacterial infection and their antibiotic susceptibility for the empiric antibiotic treatment in infants who presented with suspected infection. This study was aimed to find the most prevalent bacterial infection and antibiotic sensitivity among infants in the post-neonatal period presented at a tertiary care centre in South India.

A cross-sectional study was designed among infants (29 days to 1 year old) presented with suspected infection in the paediatric department. Infants with positive culture report were analysed for the bacteriological and antibiotic profile from the medical records. Antibiotic sensitivity was determined for the isolated bacteria according to standard procedure and data statically analysed.

Total of 218 samples (138 male and 80 female) were analysed. Most of the samples (171/218, 78.4%) were throat swab (p = 0.0247). Only one sample was cerebrospinal fluid from case of meningitis. Sample from upper RTI was major (162/218, 74.3%) with male dominance followed by stool samples from cases of diarrhoea (22/218, 10.0%). Staphylococcus aureus was the major organism identified in 46/171 (26.9 %) throat swabs. The most sensitive antibiotic against bacteria isolated from throat swab and CSF was gentamicin and cloxacillin. Netilmicin and piperacillin plus tazobactam were the sensitive antibiotics against bacteria isolated from stool, ear secretion and urine samples.

Upper RTI was the prevalent bacterial infection followed by diarrhoea in infants in the post-neonatal period. Klebsiella pneumoniae was the common organism identified in the overall report followed by E. coli and S. aureus. Community-based awareness should be provided to follow good hygiene regularly in child care. Furthermore, avoid delay in seeking treatment and provide the medicine prescribed at the right time and in the right dose to limit the morbidity and bacterial resistance.

Perinatal health is a good indicator of both maternal health status and the level of socioeconomic status attained in any community. This article presents part of the findings of a research project conducted in 1997 by the author to look at the determinants of maternal and perinatal health in Kisumu district of Kenya. Data were collected from four health facilities within the district which were selected through purposive sampling to act as sentinel centres. In total, 1,455 obstetric cases were enumerated and those with perinatal complications were isolated. Perinatal health status was measured by the frequency of low birth weights, neonatal deaths, still‐births, and early neonatal morbidity. Cross‐tabulations and multivariate analysis have been used to identify the major risk factors of the perinatal health problems identified in the study area. Among other things, the study reveals that the risk of most perinatal complications is significantly increased by maternal and environmental factors. These include poor pregnancy care, malaria and anaemia during pregnancy, poor socioeconomic conditions of the mother and poor sanitary conditions in the household. Any policy measure aimed at promoting perinatal health should seek to address all these factors.

Neonatal healthcare is a critical issue in public health management. The purpose of this paper is to analyze neonatal health in South Asia. This paper specifically examines the neonatal period of an infant's development, the time from birth to the first 28 days, and the importance of providing each newborn with the necessary vaccines, treatments, and care they may require. In addition to examining neonatal health and those diseases/problems that afflict children without proper care, a closer look will be taken at Southern Asia, where research shows nearly 75 percent of the neonatal deaths that take place in the world, occur.

An extensive literature review using recently published works, government documents, and organizational reports is employed. The research is based on case studies of six South Asian countries and several international participating agencies and non‐governmental organizations working on the improvement of neonatal health.

The research shows that the majority of the countries in this region lack the funds necessary to provide aide, health services, and other preventative care to their populations. Without the global attention, intervention, and resources provided by these organizations, any progress made in the area of neonatal health in these regions will continue to be hampered. A social marketing framework designed to address this critical public health challenge is presented.

In the modern world, much advancement has been made in terms of neonatal and maternal health and well‐being. As the years have passed, the world has seen many improvements on clinical procedures, health policies and regulations, the quality of training for doctors, nurses, and related specialists, and the various pieces of medical equipment used throughout those hospitals and clinics located within the developing world. Unfortunately, data provided by various research efforts have shown that neonatal mortality continues to occur at high rates throughout countries in South Asia. Individuals in these countries lack access to health care, health education, and other essential components that influence a mother's ability to produce a healthy child and keep that child safe and illness/issue free throughout this fragile period.

The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants.

The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations.

In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment.

Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.

Inguinal hernias are a common problem amongst neonates, and a potential source of significant morbidity through incarceration of the hernia. Expedited surgical repair can prevent incarceration and reduce complications. The department at Bristol Children's Hospital aimed to minimise waiting times for surgery thereby reducing incarceration and complication rates. This paper aims to examine how this was done.

Bristol Children's Hospital provides local and regional (tertiary referral) services. Retrospective audit of waiting times from referral to surgery was performed against the departmental standard of four weeks. Data were collected on frequency of incarceration and any complications. Following service restructure, second cycle audit was performed to assess the impact of change.

First cycle audit (n=74) found median waiting time 20 days, (Mean 28.4 days, Range 0‐138 days). A total of 28 per cent of patients waited longer than the target four weeks from referral. Incarceration occurred in 13 per cent of patients awaiting surgery. Two patients (2.7 per cent) experienced complications. Following service restructuring second cycle audit (n=28) found waiting times were significantly reduced (median two days, mean 7.0, p<0.0001). Only 7 per cent of patients waited over four weeks for surgery. There were no incarcerations or complications.

This study demonstrates a successful model of service for management of neonatal inguinal hernias which could be adopted at children's hospitals throughout the UK.

This study highlights a successful audit process, in which the extent of a problem is quantified and analysed, strategies for improvement are identified and implemented, and second cycle audit confirms the impact of change and an improved service.

The purpose of this paper is to provide a situational overview of the facility-based maternal and perinatal morbidity and mortality audits (MPMMAs) in SSA, their current efficacy at reducing mortality and morbidity rates related to childbirth.

This is a scoping literature review based on the synthesis of secondary literature.

Not all countries in SSA conduct MPMMAs. Countries where MPMMAs are conducted have not instituted standard practice, MPMMAs are not done on a national scale, and there is no clear best practice for MPMMAs. In addition, auditing process of pediatrics and maternal deaths is flawed by human and organizational barriers. Thus, the aggregated data collected from MPMMAs are not adequate enough to identify and correct systemic flaws in SSA childbirth-related health care.

There are a few published literature on the topic in sub-Saharan Africa.

This review exposes serious gaps in literature and practice. It provides a platform upon which practitioners and policy makers must begin to discuss ways of embedding mortality audits in SSA in their health systems as well as health strategies.

The findings of this paper can inform policy in sub-Saharan Africa that could lead toward better outcomes in health and well-being.

The paper is original.

This paper aims to understand the maternal health vulnerabilities of migrant women in slums and explore their challenges during and after childbirth.

The study used a qualitative approach, including in-depth interviews through purposive and snowball sampling techniques. Thematic analysis was used for analysing data. The consolidated criteria for reporting qualitative studies (COREQ)-32 items were followed for reporting this study.

The study found that migrant women were highly susceptible to adverse birthing outcomes due to risks involved in birthing, lack of care and hygiene, lack of skilled care in dealing with complicated pregnancies and exposure to domestic and obstetric violence.

The study intends to highlight the narratives of female migrants’ birthing and maternal health challenges. The entire process of childbirth in slums with consequences can result in maternal and infant morbidities and mortalities.

The purpose of this paper is to describe a quality improvement (QI) intervention in primary health facilities providing childbirth care in rural Southern Tanzania.

A QI collaborative model involving district managers and health facility staff was piloted for 6 months in 4 health facilities in Mtwara Rural district and implemented for 18 months in 23 primary health facilities in Ruangwa district. The model brings together healthcare providers from different health facilities in interactive workshops by: applying QI methods to generate and test change ideas in their own facilities; using local data to monitor improvement and decision making; and health facility supervision visits by project and district mentors. The topics for improving childbirth were deliveries and partographs.

Median monthly deliveries increased in 4 months from 38 (IQR 37-40) to 65 (IQR 53-71) in Mtwara Rural district, and in 17 months in Ruangwa district from 110 (IQR 103-125) to 161 (IQR 148-174). In Ruangwa health facilities, the women for whom partographs were used to monitor labour progress increased from 10 to 57 per cent in 17 months.

The time for QI innovation, testing and implementation phases was limited, and the study only looked at trends. The outcomes were limited to process rather than health outcome measures.

Healthcare providers became confident in the QI method through engagement, generating and testing their own change ideas, and observing improvements. The findings suggest that implementing a QI initiative is feasible in rural, low-income settings.