Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study

Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A colla...

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Main Authors: Hippolite O. Amadi, Akin O. Osibogun, Olateju Eyinade, Mohammed B. Kawuwa, Angela C. Uwakwem, Maryann U. Ibekwe, Peter Alabi, Chinyere Ezeaka, Dada G. Eleshin, Mike O. Ibadin
Format: Article
Language:English
Published: Wiley 2014-01-01
Series:International Journal of Pediatrics
Online Access:http://dx.doi.org/10.1155/2014/986716
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author Hippolite O. Amadi
Akin O. Osibogun
Olateju Eyinade
Mohammed B. Kawuwa
Angela C. Uwakwem
Maryann U. Ibekwe
Peter Alabi
Chinyere Ezeaka
Dada G. Eleshin
Mike O. Ibadin
author_facet Hippolite O. Amadi
Akin O. Osibogun
Olateju Eyinade
Mohammed B. Kawuwa
Angela C. Uwakwem
Maryann U. Ibekwe
Peter Alabi
Chinyere Ezeaka
Dada G. Eleshin
Mike O. Ibadin
author_sort Hippolite O. Amadi
collection DOAJ
description Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one “control” were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.
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spelling doaj-art-738fafe2a5814bff933a164ef9b3f1ec2025-02-03T05:51:45ZengWileyInternational Journal of Pediatrics1687-97401687-97592014-01-01201410.1155/2014/986716986716Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative StudyHippolite O. Amadi0Akin O. Osibogun1Olateju Eyinade2Mohammed B. Kawuwa3Angela C. Uwakwem4Maryann U. Ibekwe5Peter Alabi6Chinyere Ezeaka7Dada G. Eleshin8Mike O. Ibadin9Department of Bioengineering, Imperial College London, South Kensington Campus, SW7 2AZ, UKDepartments of Community Health and Paediatrics, Lagos University Teaching Hospital, PMB 12003, Lagos 101001, NigeriaDepartment of Paediatrics, University of Abuja Teaching Hospital, PMB 228, Abuja 900001, NigeriaDepartment Obstetrics and Gynaecology, Federal Medical Centre Nguru, Nguru 630001, NigeriaFederal Medical Centre Owerri, Owerri 460001, NigeriaDepartment of Paediatrics, Federal Teaching Hospital Abakaliki, Abakaliki 480001, NigeriaDepartment of Paediatrics, University of Abuja Teaching Hospital, PMB 228, Abuja 900001, NigeriaDepartments of Community Health and Paediatrics, Lagos University Teaching Hospital, PMB 12003, Lagos 101001, NigeriaFederal Medical Centre Lokoja, Lokoja 260001, NigeriaUniversity of Benin Teaching Hospital, P.O. Box 1111, Benin-City 300001, NigeriaMillennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one “control” were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.http://dx.doi.org/10.1155/2014/986716
spellingShingle Hippolite O. Amadi
Akin O. Osibogun
Olateju Eyinade
Mohammed B. Kawuwa
Angela C. Uwakwem
Maryann U. Ibekwe
Peter Alabi
Chinyere Ezeaka
Dada G. Eleshin
Mike O. Ibadin
Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study
International Journal of Pediatrics
title Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study
title_full Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study
title_fullStr Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study
title_full_unstemmed Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study
title_short Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study
title_sort challenges and frugal remedies for lowering facility based neonatal mortality and morbidity a comparative study
url http://dx.doi.org/10.1155/2014/986716
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