Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study
Background Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts to monitor and...
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BMJ Publishing Group
2021-05-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/6/5/e004475.full |
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| author | Grace Irimu Morris Ogero George Mbevi David Gathara Samuel Akech Mike English Jalemba Aluvaala Ambrose Agweyu Mercy Chepkirui Sylvia Omoke Lucas Malla Emma Namulala Juma Vitalis Rachel Inginia Grace Ochieng Lydia Thuranira Esther Njiru Charles Nzioki Caren Emadau Christine Manyasi Fred Were Magdalene Kuria Mary Waiyego Beth Maina Edith Gicheha Joseph Nganga Esther Mwangi Esther Muthiani Mary Nguri Samuel Soita Margaret Waweru Alfred Wanjau Caroline Mwangi John Wainaina Livingstone Mumelo Nyumbile Bonface Wagura Mwangi Penina Mwangi Felistus Makokha Josephine Ojigo Bernadette Lusweti Amilia Ngoda Dolphine Mochache Jane Mbungu Joan Baswetty Josephine Aritho Beatrice Njambi Zainab Kioni Lucy Kinyua Alice Oguda Loise N. Mwangi Nancy Mburu Celestine Muteshi Salome Okisa Muyale Faith Mueni Rosemary Mututa Joyce Oketch Orina Nyakina Faith Njeru Margaret Wanjiku Mwaura Seline Kulubi Susan Wanjala Pauline Njeru John Ollongo Otieno George Obop Jeska Kuya Benjamin Tanui Judith Onsongo Peter Muigai Arnest Namayi |
| author_facet | Grace Irimu Morris Ogero George Mbevi David Gathara Samuel Akech Mike English Jalemba Aluvaala Ambrose Agweyu Mercy Chepkirui Sylvia Omoke Lucas Malla Emma Namulala Juma Vitalis Rachel Inginia Grace Ochieng Lydia Thuranira Esther Njiru Charles Nzioki Caren Emadau Christine Manyasi Fred Were Magdalene Kuria Mary Waiyego Beth Maina Edith Gicheha Joseph Nganga Esther Mwangi Esther Muthiani Mary Nguri Samuel Soita Margaret Waweru Alfred Wanjau Caroline Mwangi John Wainaina Livingstone Mumelo Nyumbile Bonface Wagura Mwangi Penina Mwangi Felistus Makokha Josephine Ojigo Bernadette Lusweti Amilia Ngoda Dolphine Mochache Jane Mbungu Joan Baswetty Josephine Aritho Beatrice Njambi Zainab Kioni Lucy Kinyua Alice Oguda Loise N. Mwangi Nancy Mburu Celestine Muteshi Salome Okisa Muyale Faith Mueni Rosemary Mututa Joyce Oketch Orina Nyakina Faith Njeru Margaret Wanjiku Mwaura Seline Kulubi Susan Wanjala Pauline Njeru John Ollongo Otieno George Obop Jeska Kuya Benjamin Tanui Judith Onsongo Peter Muigai Arnest Namayi |
| author_sort | Grace Irimu |
| collection | DOAJ |
| description | Background Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts to monitor and promote improvements in the quality of newborn care across hospitals.Methods Continuously collected routine patients’ data from structured paper record forms for all admissions to newborn units (NBUs) from 16 purposively selected Kenyan public hospitals that are part of a clinical information network were analysed together with data from all paediatric admissions ages 0–13 years from 14 of these hospitals. Data are used to show the proportion of all admissions and deaths in the neonatal age group and examine morbidity and mortality patterns, stratified by birth weight, and their variation across hospitals.Findings During the 354 hospital months study period, 90 222 patients were admitted to the 14 hospitals contributing NBU and general paediatric ward data. 46% of all the admissions were neonates (aged 0–28 days), but they accounted for 66% of the deaths in the age group 0–13 years. 41 657 inborn neonates were admitted in the NBUs across the 16 hospitals during the study period. 4266/41 657 died giving a crude mortality rate of 10.2% (95% CI 9.97% to 10.55%), with 60% of these deaths occurring on the first-day of admission. Intrapartum-related complications was the single most common diagnosis among the neonates with birth weight of 2000 g or more who died. A threefold variation in mortality across hospitals was observed for birth weight categories 1000–1499 g and 1500–1999 g.Interpretation The high proportion of neonatal deaths in hospitals may reflect changing patterns of childhood mortality. Majority of newborns died of preventable causes (>95%). Despite availability of high-impact low-cost interventions, hospitals have high and very variable mortality proportions after stratification by birth weight. |
| format | Article |
| id | doaj-art-0a0cfc4b105a43c7af5a4f96fc55bd9c |
| institution | OA Journals |
| issn | 2059-7908 |
| language | English |
| publishDate | 2021-05-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-0a0cfc4b105a43c7af5a4f96fc55bd9c2025-08-20T02:09:48ZengBMJ Publishing GroupBMJ Global Health2059-79082021-05-016510.1136/bmjgh-2020-004475Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort studyGrace Irimu0Morris Ogero1George Mbevi2David Gathara3Samuel Akech4Mike English5Jalemba Aluvaala6Ambrose Agweyu7Mercy ChepkiruiSylvia Omoke8Lucas Malla9Emma NamulalaJuma VitalisRachel InginiaGrace OchiengLydia ThuraniraEsther NjiruCharles NziokiCaren EmadauChristine ManyasiFred Were10Magdalene KuriaMary Waiyego11Beth MainaEdith Gicheha12Joseph NgangaEsther MwangiEsther MuthianiMary NguriSamuel SoitaMargaret WaweruAlfred WanjauCaroline Mwangi13John WainainaLivingstone MumeloNyumbile BonfaceWagura MwangiPenina MwangiFelistus MakokhaJosephine OjigoBernadette LuswetiAmilia NgodaDolphine MochacheJane MbunguJoan BaswettyJosephine ArithoBeatrice NjambiZainab KioniLucy KinyuaAlice OgudaLoise N. MwangiNancy MburuCelestine MuteshiSalome Okisa MuyaleFaith MueniRosemary MututaJoyce OketchOrina NyakinaFaith NjeruMargaret Wanjiku MwauraSeline KulubiSusan WanjalaPauline NjeruJohn OllongoOtieno George ObopJeska KuyaBenjamin TanuiJudith OnsongoPeter MuigaiArnest NamayiprofessorHealth Services Unit, KEMRI – Wellcome Trust Research Institute, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya2 KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya1 Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya1 Health Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya10Department of Paediatrics, University of NairobiEpidemiology and Demography, KEMRI—Wellcome Trust Research Institute, Nairobi, KenyaHealth Services Unit, KEMRI – Wellcome Trust Research Institute, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme Nairobi, Nairobi, Kenya11 Department of Paediatrics and Child Health, University of Nairobi, Nairobi, KenyaDepartment of Pediatrics, Pumwani Maternity Hospital, Nairobi, KenyaHealth Services Unit, KEMRI-Wellcome Trust Research Programme, Nairobi, KenyaDivision of Neonatal and Child Health, Kenya Ministry of Health, Nairobi, KenyaBackground Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts to monitor and promote improvements in the quality of newborn care across hospitals.Methods Continuously collected routine patients’ data from structured paper record forms for all admissions to newborn units (NBUs) from 16 purposively selected Kenyan public hospitals that are part of a clinical information network were analysed together with data from all paediatric admissions ages 0–13 years from 14 of these hospitals. Data are used to show the proportion of all admissions and deaths in the neonatal age group and examine morbidity and mortality patterns, stratified by birth weight, and their variation across hospitals.Findings During the 354 hospital months study period, 90 222 patients were admitted to the 14 hospitals contributing NBU and general paediatric ward data. 46% of all the admissions were neonates (aged 0–28 days), but they accounted for 66% of the deaths in the age group 0–13 years. 41 657 inborn neonates were admitted in the NBUs across the 16 hospitals during the study period. 4266/41 657 died giving a crude mortality rate of 10.2% (95% CI 9.97% to 10.55%), with 60% of these deaths occurring on the first-day of admission. Intrapartum-related complications was the single most common diagnosis among the neonates with birth weight of 2000 g or more who died. A threefold variation in mortality across hospitals was observed for birth weight categories 1000–1499 g and 1500–1999 g.Interpretation The high proportion of neonatal deaths in hospitals may reflect changing patterns of childhood mortality. Majority of newborns died of preventable causes (>95%). Despite availability of high-impact low-cost interventions, hospitals have high and very variable mortality proportions after stratification by birth weight.https://gh.bmj.com/content/6/5/e004475.full |
| spellingShingle | Grace Irimu Morris Ogero George Mbevi David Gathara Samuel Akech Mike English Jalemba Aluvaala Ambrose Agweyu Mercy Chepkirui Sylvia Omoke Lucas Malla Emma Namulala Juma Vitalis Rachel Inginia Grace Ochieng Lydia Thuranira Esther Njiru Charles Nzioki Caren Emadau Christine Manyasi Fred Were Magdalene Kuria Mary Waiyego Beth Maina Edith Gicheha Joseph Nganga Esther Mwangi Esther Muthiani Mary Nguri Samuel Soita Margaret Waweru Alfred Wanjau Caroline Mwangi John Wainaina Livingstone Mumelo Nyumbile Bonface Wagura Mwangi Penina Mwangi Felistus Makokha Josephine Ojigo Bernadette Lusweti Amilia Ngoda Dolphine Mochache Jane Mbungu Joan Baswetty Josephine Aritho Beatrice Njambi Zainab Kioni Lucy Kinyua Alice Oguda Loise N. Mwangi Nancy Mburu Celestine Muteshi Salome Okisa Muyale Faith Mueni Rosemary Mututa Joyce Oketch Orina Nyakina Faith Njeru Margaret Wanjiku Mwaura Seline Kulubi Susan Wanjala Pauline Njeru John Ollongo Otieno George Obop Jeska Kuya Benjamin Tanui Judith Onsongo Peter Muigai Arnest Namayi Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study BMJ Global Health |
| title | Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
| title_full | Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
| title_fullStr | Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
| title_full_unstemmed | Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
| title_short | Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
| title_sort | neonatal mortality in kenyan hospitals a multisite retrospective cohort study |
| url | https://gh.bmj.com/content/6/5/e004475.full |
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