Tette Edem M A, Nuertey Benjamin Demah, Azusong Emmanuel A, Gandau Naa Barnabas
Department of Community Health, University of Ghana Medical School, P.O. Box 4236, Accra, Ghana.
Public Health Department, Tamale Teaching Hospital, P.O. Box, TL 16, Tamale, Ghana.
Children (Basel). 2020 Feb 18;7(2):15. doi: 10.3390/children7020015.
Neonatal mortality is the major contributor to under-five mortality rates in many low and middle income countries. We examined the health practices, care-seeking behavior, and referral of sick outborn neonates to a district and regional hospital in the Upper West Region of Ghana. The study was a cross-sectional study conducted over an eight (8) month period in 2018. Data were obtained from caregiver interviews and case notes. Altogether, 153 outborn neonates were examined. Inappropriate practices including the use of enemas, cord care with cow dung, and herbal baths were found. Three babies treated this way died. The majority of caregivers sought care at a health facility. However, 67 (44%) sought care only after their babies were ill for ≥7 days, suggesting the influence of a period of confinement on health seeking. More than half, 94 (61.4%), of the facilities visited referred patients to destination hospitals without giving any treatment. Delayed care-seeking was associated with a low birth weight, using home remedies, and a maternal age of ≥30 years. Altogether, 12 neonates (7.8%) died, consisting of three males and nine females ( = 0.018). Socio-cultural factors strongly influence health seeking behavior and the health outcome of neonates in this setting. There appeared to be a limited repertoire of interventions for treating neonatal disease in primary care.
在许多低收入和中等收入国家，新生儿死亡率是五岁以下儿童死亡率的主要构成因素。我们调查了加纳上西部地区患病的外地出生新生儿的健康习惯、就医行为以及转诊至地区和区域医院的情况。该研究是一项在2018年为期八（8）个月的横断面研究。数据通过对照顾者的访谈和病例记录获得。总共检查了153名外地出生的新生儿。发现了一些不当做法，包括使用灌肠剂、用牛粪护理脐带以及草药浴。以这种方式治疗的三名婴儿死亡。大多数照顾者在医疗机构寻求护理。然而，67名（44%）照顾者在其婴儿患病≥7天后才寻求护理，这表明产褥期对就医行为有影响。超过一半（94名，61.4%）的就诊机构将患者转诊至目的地医院，未给予任何治疗。延迟就医与低出生体重、使用家庭疗法以及母亲年龄≥30岁有关。总共12名新生儿（7.8%）死亡，其中三名男性和九名女性（ = 0.018）。在这种情况下，社会文化因素强烈影响新生儿的就医行为和健康结局。初级保健中治疗新生儿疾病的干预措施似乎有限。
