Ekanem Emmanuel E, Fajola Akinwumi O, Ande Adedapo B, Ikeagwu Gloria O, Anidima Tamunoibim E, Umejiego Chidozie N, Usman Rakiya
Department of Paediatrics, University of Calabar, Calabar, Nigeria.
Department of Community Health, Shell Petroleum and Development Company, Abuja, Nigeria.
Niger Med J. 2020 Jul-Aug;61(4):206-209. doi: 10.4103/nmj.NMJ_162_19. Epub 2020 Aug 4.
Neonatal morbidity and mortality are high in Nigeria. The establishment of more centers that could offer adequate management of high-risk pregnancies and neonates is essential.
This study seeks to describe sick newborn care at the cottage hospital level in Southern Nigeria with the aim of drawing lessons that may be useful to similar environments.
A description of facility upgrading and staff training in perinatal care at a public-private partnership cottage hospital with a robust community health insurance scheme in Nigeria is made. A retrospective descriptive study of the morbidity and outcomes of admitted neonates in the facility between March 2016 and February 2017 was made.
Out of 3630 babies born in the facility (302 per month), 189 were admitted, yielding an admission rate of 52.1/1000 live births. The main morbidities were neonatal hypoglycemia (32.4%), preterm low-birth weight (24.9%), neonatal sepsis (22.8%), and neonatal jaundice (12.7%). Sixteen of the 109 neonates died giving a mortality rate of 8.5%. The main causes of deaths were birth asphyxia (7 or 43.8%), meconium aspiration (6 or 37.5%), and congenital malformation (3 or 18.8%).
The neonatal admission and mortality rates are quite low in this cottage hospital and similar to the situation even in developed environments. This salutary scenario is probably due to good antenatal and perinatal care, and a robust community health insurance scheme which enhances services uptake and public-private partnership which engenders infrastructure expansion and maintenance. This model is recommended for the hospitals in our region.
尼日利亚新生儿的发病率和死亡率很高。建立更多能够为高危妊娠和新生儿提供充分管理的中心至关重要。
本研究旨在描述尼日利亚南部乡村医院层面的患病新生儿护理情况，以期吸取对类似环境可能有用的经验教训。
对尼日利亚一家公私合营的乡村医院围产期护理的设施升级和人员培训进行了描述。对该机构2016年3月至2017年2月期间收治的新生儿的发病率和结局进行了回顾性描述性研究。
该机构共出生3630名婴儿（每月302名），其中189名入院，入院率为52.1/1000活产。主要疾病为新生儿低血糖（32.4%）、早产低体重（24.9%）、新生儿败血症（22.8%）和新生儿黄疸（12.7%）。109名新生儿中有16名死亡，死亡率为8.5%。主要死亡原因是出生窒息（7例，占43.8%）、胎粪吸入（6例，占37.5%）和先天性畸形（3例，占18.8%）。
这家乡村医院的新生儿入院率和死亡率相当低，即使在发达环境中也是如此。这种良好的情况可能归因于良好的产前和围产期护理、强大的社区医疗保险计划（该计划提高了服务利用率）以及公私合营（这带来了基础设施的扩展和维护）。推荐本地区的医院采用这种模式。
