Amhara Regional Health Bureau, Bahir Dar, Ethiopia.
School of Public Health, Collage of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
BMC Health Serv Res. 2024 Oct 3;24(1):1173. doi: 10.1186/s12913-024-11681-x.
Neonatal health is one of the targets for the sustainable development goals (SDGs) that aim to reduce neonatal mortality to at least as low as 12 per 1 000 live births in 2030. However, the world is not on track to achieve this target. The problem has worsened in many low-income countries, including Ethiopia, due to a fragile health system, as well as health crises such as the COVID-19 pandemic, conflict, food insecurity and climate change. According to the Mini Ethiopian Demographic Health Survey, neonatal mortality is unacceptably high in Ethiopia in general, and in Amhara region in particular. Despite these facts, there is a paucity of information on the quality of neonatal health service provision in comprehensive specialized hospitals in Amhara region. Therefore, this study is aimed at assessing the quality of neonatal health services in terms of outcome (neonatal mortality) and its causes in comprehensive specialized hospitals in Amhara region.
A multi-center retrospective study was conducted (from September 1-30/2022) on 315 neonates in four comprehensive hospitals with chart review. Data were collected through death audit with standardized neonatal death audit tool. Data were entered into Epi-data 3.1 and exported to SPSS 20 for analysis. Descriptive analysis was used to describe and summarize the data in an informative manner.
From 315 neonatal deaths, about two-thirds, 205 (65.1%), were from rural areas. Nearly half, 151 (48%), of the mothers had complications and delivered outside a health facility. About 36 (11.4%), 45 (14.3%), and 21 (6.7%) neonates' mothers had 1st, 2nd, and 3rd delays, respectively. About 59 (19%) of mothers had membrane rupture before the onset of labor and 23 (7.3%) had meconium-stained liquor. Almost three-fourths, 226 (71.7%), of the deaths were low birth weight (< 2500 gram). About 25 (8%) of neonates had congenital anomalies, 65% of them had fast breathing and 54.6% were preterm.
Higher proportions of neonatal deaths were observed among neonates with rural residence, low birth weight, mothers' complications and neonates admitted for fast breathing. Histories of abortion, complications, congenital anomalies, and the 3 delays contributed to neonatal deaths.
新生儿健康是可持续发展目标（SDGs）的目标之一，旨在将新生儿死亡率在 2030 年降低到每 1000 例活产中至少 12 例。然而，世界尚未走上实现这一目标的轨道。由于卫生系统脆弱，以及 COVID-19 大流行、冲突、粮食不安全和气候变化等卫生危机，许多低收入国家，包括埃塞俄比亚，这一问题已经恶化。根据《迷你埃塞俄比亚人口健康调查》，埃塞俄比亚新生儿死亡率总体上居高不下，特别是在阿姆哈拉地区。尽管存在这些事实，但关于阿姆哈拉地区综合性专科医院提供新生儿保健服务质量的信息却很少。因此，本研究旨在评估阿姆哈拉地区综合性专科医院的新生儿保健服务质量，具体指标为（新生儿）结局（即新生儿死亡率）及其原因。
采用多中心回顾性研究方法（2022 年 9 月 1 日至 30 日），对四家综合性医院的 315 例新生儿进行病历回顾。通过使用标准化新生儿死亡审核工具进行死亡审核收集数据。数据录入 Epi-data 3.1 并导出至 SPSS 20 进行分析。采用描述性分析对数据进行描述和总结，以提供有意义的信息。
在 315 例新生儿死亡中，约三分之二，即 205 例（65.1%），来自农村地区。将近一半，即 151 例（48%）母亲在分娩时出现并发症且在医疗机构外分娩。约 36 例（11.4%）、45 例（14.3%）和 21 例（6.7%）新生儿的母亲分别延迟 1 次、2 次和 3 次。约 59 例（19%）母亲胎膜破裂发生在分娩开始之前，23 例（7.3%）羊水呈胎粪样。近四分之三，即 226 例（71.7%）死亡的新生儿为低出生体重（<2500 克）。约 25 例（8%）新生儿存在先天性异常，其中 65%存在呼吸急促，54.6%为早产儿。
农村地区新生儿、低出生体重儿、母亲并发症以及因呼吸急促入院的新生儿中，新生儿死亡率比例较高。流产史、并发症、先天性异常和 3 次延迟均导致新生儿死亡。
