Tosif Shidan, Nasi Titus, Gray Amy, Sadr-Azodi Nahad, Ogaoga Divi, Duke Trevor
Centre for International Child Health, University of Melbourne, Melbourne, Victoria, Australia.
Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2018 Feb;54(2):165-171. doi: 10.1111/jpc.13686. Epub 2017 Sep 14.
To identify strengths and obstacles for improving the quality of newborn care in the Solomon Islands. Improving the quality of newborn care is a priority in the Sustainable Development Goals and the Action Plan for Healthy Newborns in the Western Pacific. The neonatal mortality rate in the Solomon Islands, a lower-middle-income country, has improved slower than overall child mortality. In 2013, neonatal mortality (13.2/1000) constituted 44% of under-5 deaths (30.1/1000).
A cross-sectional study of newborn care in five provincial hospitals using a World Health Organization assessment tool for hospital quality of care. Twelve months of neonatal records of the National Referral Hospital (NRH) labour ward and nursery were audited.
Essential medications and basic equipment were generally available. Challenges included workforce shortages and lack of expertise, high costs, organisation and maintenance of equipment, infection control and high rates of stillbirth. Over 12 months at the NRH labour ward, there were 5412 live births, 65 (1.2%) 'fresh' stillbirths and 96 (1.8%) 'macerated' stillbirths. Over the same period, there were an associated 779 nursery admissions, and the main causes of mortality were complications of prematurity, birth asphyxia, congenital abnormalities and sepsis. Total neonatal mortality at NRH was 16 per 1000 live births, and 77% of deaths occurred in the first 3 days of life.
Infrastructure limitations, technical maintenance and equipment organisation were obstacles to newborn care. Greater health-care worker knowledge and skills for early essential newborn care, infection control and management of newborn complications is needed.
确定在所罗门群岛提高新生儿护理质量的优势和障碍。提高新生儿护理质量是可持续发展目标以及西太平洋健康新生儿行动计划中的一项优先事项。所罗门群岛作为一个中低收入国家，其新生儿死亡率的改善速度比儿童总体死亡率的改善速度要慢。2013年，新生儿死亡率（13.2‰）占5岁以下儿童死亡（30.1‰）的44%。
使用世界卫生组织的医院护理质量评估工具，对五家省级医院的新生儿护理进行横断面研究。对国家转诊医院（NRH）产房和新生儿病房的12个月新生儿记录进行了审核。
基本药物和基本设备总体上是可用的。挑战包括劳动力短缺、缺乏专业知识、成本高昂、设备的组织和维护、感染控制以及死产率高。在NRH产房的12个月期间，有5412例活产，65例（1.2%）“新鲜”死产和96例（1.8%）“浸软”死产。在同一时期，有779例新生儿入住新生儿病房，死亡的主要原因是早产并发症、出生窒息、先天性异常和败血症。NRH的新生儿总死亡率为每1000例活产16例，77%的死亡发生在生命的前3天。
基础设施限制、技术维护和设备组织是新生儿护理的障碍。需要医护人员具备更多关于早期基本新生儿护理、感染控制和新生儿并发症管理的知识和技能。
