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新生儿转运网络服务:尼日利亚南部医疗系统的准备情况

Neonatal Transport Network Services: Preparedness of healthcare systems in Southern Nigeria.

作者信息

Okorie Elizabeth-Martha Chinyere, Briggs Datonye Christopher, Opara Peace Ibo, Eneh Augusta Unoma

机构信息

Department of Paediatrics, Pamo University of Medical Sciences, Port Harcourt, Nigeria.

Department of Paediatrics, Rivers State University Teaching Hospital, Port Harcourt, Nigeria.

出版信息

Niger Med J. 2024 Jun 20;65(3):332-343. doi: 10.60787/nmj-v65i3-471. eCollection 2024 May-Jun.

Abstract

BACKGROUND

Nigeria remains a major contributor to neonatal deaths worldwide, yet little consideration has been given to intra/inter health facility transfer of sick neonates. The dearth of Neonatal Transport Network Services (NNTS) is probably an underappreciated driver of the abysmally high national neonatal mortality indices. This study aimed to evaluate neonatal transport services and the healthcare workers' preparedness among health facilities in Port Harcourt Metropolis, Rivers State, Nigeria.

METHODS

Twenty-eight selected health facilities (tertiary, private hospitals Primary Health Centers] were assessed on the availability, modality and practice of NNTS. Data was analyzed using SPSS Version 23.

RESULTS

Routine transfer of high-risk pregnant mothers to higher levels of care occurred always in 14 (50%) and sometimes in 6 (21.4%) facilities; Private cars and taxis were the most common mode of transport in 24 (85.7%) facilities. Two facilities (7.2%) had ambulances equipped with transport incubators. Nurses and nurse attendants with no formal training in NNTS accompanied referred neonates in 2 (7.2%) facilities. Most referring facilities (78.6%) neither rarely or never contacted receiving centres before the arrival of neonates and most nor gave back referrals after offering neonatal care. None (100%) of the facilities had a trained emergency transport team.

CONCLUSION

Health facilities in Southern Nigeria lack a standardized Neonatal Transport Network and are characterized by poor communication between health facilities and inadequately trained personnel for inter-facility transfer of sick neonates. Urgent action is required to address these gaps, including training of healthcare workers on neonatal transport and sharing findings with relevant stakeholders/policymakers to establish a functional neonatal transport network among health facilities.

摘要

背景

尼日利亚仍是全球新生儿死亡的主要贡献国,但对于患病新生儿在医疗机构内部/之间的转运却很少受到关注。新生儿转运网络服务(NNTS)的匮乏可能是该国新生儿死亡率高得惊人的一个未得到充分认识的驱动因素。本研究旨在评估尼日利亚河流州哈科特港大都会地区医疗机构的新生儿转运服务以及医护人员的准备情况。

方法

对28家选定的医疗机构(三级医院、私立医院、初级卫生中心)的NNTS的可用性、模式和实践进行了评估。使用SPSS 23版对数据进行分析。

结果

14家(50%)医疗机构总是将高危孕妇常规转诊至更高水平的医疗机构进行治疗,6家(21.4%)有时会这样做;24家(85.7%)医疗机构最常用的转运方式是私家车和出租车。两家(7.2%)医疗机构配备了带有转运暖箱的救护车。在两家(7.2%)医疗机构中,没有接受过NNTS正规培训的护士和护理人员陪同转诊的新生儿。大多数转诊医疗机构(78.6%)在新生儿到达之前很少或从未与接收中心联系,并且大多数在提供新生儿护理后也没有反馈转诊情况。所有(100%)医疗机构均没有经过培训的紧急转运团队。

结论

尼日利亚南部的医疗机构缺乏标准化的新生儿转运网络,其特点是医疗机构之间沟通不畅,且负责患病新生儿机构间转运的人员培训不足。需要采取紧急行动来弥补这些差距,包括对医护人员进行新生儿转运培训,并与相关利益攸关方/政策制定者分享研究结果,以在医疗机构之间建立一个有效的新生儿转运网络。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5dbe/11249475/edb4e9907255/nmj-65-332-f1.jpg

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