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...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Grace Irimu [verfasserIn] Morris Ogero [verfasserIn] George Mbevi [verfasserIn] David Gathara [verfasserIn] Samuel Akech [verfasserIn] Jalemba Aluvaala [verfasserIn] Ambrose Agweyu [verfasserIn] Mercy Chepkirui [verfasserIn] Sylvia Omoke [verfasserIn] Emma Namulala [verfasserIn] Juma Vitalis [verfasserIn] Rachel Inginia [verfasserIn] Grace Ochieng [verfasserIn] Lydia Thuranira [verfasserIn] Esther Njiru [verfasserIn] Charles Nzioki [verfasserIn] Caren Emadau [verfasserIn] Christine Manyasi [verfasserIn] Fred Were [verfasserIn] Magdalene Kuria [verfasserIn] Mary Waiyego [verfasserIn] Beth Maina [verfasserIn] Edith Gicheha [verfasserIn] Joseph Nganga [verfasserIn] Esther Mwangi [verfasserIn] Esther Muthiani [verfasserIn] Mary Nguri [verfasserIn] Samuel Soita [verfasserIn] Margaret Waweru [verfasserIn] Alfred Wanjau [verfasserIn] Caroline Mwangi [verfasserIn] John Wainaina [verfasserIn] Livingstone Mumelo [verfasserIn] Nyumbile Bonface [verfasserIn] Wagura Mwangi [verfasserIn] Penina Mwangi [verfasserIn] Felistus Makokha [verfasserIn] Josephine Ojigo [verfasserIn] Bernadette Lusweti [verfasserIn] Amilia Ngoda [verfasserIn] Dolphine Mochache [verfasserIn] Jane Mbungu [verfasserIn] Joan Baswetty [verfasserIn] Josephine Aritho [verfasserIn] Beatrice Njambi [verfasserIn] Zainab Kioni [verfasserIn] Lucy Kinyua [verfasserIn] Alice Oguda [verfasserIn] Loise N. Mwangi [verfasserIn] Nancy Mburu [verfasserIn] Celestine Muteshi [verfasserIn] Salome Okisa Muyale [verfasserIn] Faith Mueni [verfasserIn] Rosemary Mututa [verfasserIn] Joyce Oketch [verfasserIn] Orina Nyakina [verfasserIn] Faith Njeru [verfasserIn] Margaret Wanjiku Mwaura [verfasserIn] Seline Kulubi [verfasserIn] Susan Wanjala [verfasserIn] Pauline Njeru [verfasserIn] John Ollongo [verfasserIn] Otieno George Obop [verfasserIn] Jeska Kuya [verfasserIn] Benjamin Tanui [verfasserIn] Judith Onsongo [verfasserIn] Peter Muigai [verfasserIn] Arnest Namayi [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2021 |
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| Übergeordnetes Werk: |
In: BMJ Global Health - BMJ Publishing Group, 2018, 6(2021), 5 |
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| Übergeordnetes Werk: |
volume:6 ; year:2021 ; number:5 |
| Links: |
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| DOI / URN: |
10.1136/bmjgh-2020-004475 |
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| Katalog-ID: |
DOAJ019044275 |
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| 245 | 1 | 0 | |a Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
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| 520 | |a 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. | ||
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| 653 | 0 | |a Infectious and parasitic diseases | |
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10.1136/bmjgh-2020-004475 doi (DE-627)DOAJ019044275 (DE-599)DOAJ0a0cfc4b105a43c7af5a4f96fc55bd9c DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Grace Irimu verfasserin aut Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Medicine (General) Infectious and parasitic diseases Morris Ogero verfasserin aut George Mbevi verfasserin aut David Gathara verfasserin aut Samuel Akech verfasserin aut Jalemba Aluvaala verfasserin aut Ambrose Agweyu verfasserin aut Mercy Chepkirui verfasserin aut Sylvia Omoke verfasserin aut Emma Namulala verfasserin aut Juma Vitalis verfasserin aut Rachel Inginia verfasserin aut Grace Ochieng verfasserin aut Lydia Thuranira verfasserin aut Esther Njiru verfasserin aut Charles Nzioki verfasserin aut Caren Emadau verfasserin aut Christine Manyasi verfasserin aut Fred Were verfasserin aut Magdalene Kuria verfasserin aut Mary Waiyego verfasserin aut Beth Maina verfasserin aut Edith Gicheha verfasserin aut Joseph Nganga verfasserin aut Esther Mwangi verfasserin aut Esther Muthiani verfasserin aut Mary Nguri verfasserin aut Samuel Soita verfasserin aut Margaret Waweru verfasserin aut Alfred Wanjau verfasserin aut Caroline Mwangi verfasserin aut John Wainaina verfasserin aut Livingstone Mumelo verfasserin aut Nyumbile Bonface verfasserin aut Wagura Mwangi verfasserin aut Penina Mwangi verfasserin aut Felistus Makokha verfasserin aut Josephine Ojigo verfasserin aut Bernadette Lusweti verfasserin aut Amilia Ngoda verfasserin aut Dolphine Mochache verfasserin aut Jane Mbungu verfasserin aut Joan Baswetty verfasserin aut Josephine Aritho verfasserin aut Beatrice Njambi verfasserin aut Zainab Kioni verfasserin aut Lucy Kinyua verfasserin aut Alice Oguda verfasserin aut Loise N. 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10.1136/bmjgh-2020-004475 doi (DE-627)DOAJ019044275 (DE-599)DOAJ0a0cfc4b105a43c7af5a4f96fc55bd9c DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Grace Irimu verfasserin aut Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Medicine (General) Infectious and parasitic diseases Morris Ogero verfasserin aut George Mbevi verfasserin aut David Gathara verfasserin aut Samuel Akech verfasserin aut Jalemba Aluvaala verfasserin aut Ambrose Agweyu verfasserin aut Mercy Chepkirui verfasserin aut Sylvia Omoke verfasserin aut Emma Namulala verfasserin aut Juma Vitalis verfasserin aut Rachel Inginia verfasserin aut Grace Ochieng verfasserin aut Lydia Thuranira verfasserin aut Esther Njiru verfasserin aut Charles Nzioki verfasserin aut Caren Emadau verfasserin aut Christine Manyasi verfasserin aut Fred Were verfasserin aut Magdalene Kuria verfasserin aut Mary Waiyego verfasserin aut Beth Maina verfasserin aut Edith Gicheha verfasserin aut Joseph Nganga verfasserin aut Esther Mwangi verfasserin aut Esther Muthiani verfasserin aut Mary Nguri verfasserin aut Samuel Soita verfasserin aut Margaret Waweru verfasserin aut Alfred Wanjau verfasserin aut Caroline Mwangi verfasserin aut John Wainaina verfasserin aut Livingstone Mumelo verfasserin aut Nyumbile Bonface verfasserin aut Wagura Mwangi verfasserin aut Penina Mwangi verfasserin aut Felistus Makokha verfasserin aut Josephine Ojigo verfasserin aut Bernadette Lusweti verfasserin aut Amilia Ngoda verfasserin aut Dolphine Mochache verfasserin aut Jane Mbungu verfasserin aut Joan Baswetty verfasserin aut Josephine Aritho verfasserin aut Beatrice Njambi verfasserin aut Zainab Kioni verfasserin aut Lucy Kinyua verfasserin aut Alice Oguda verfasserin aut Loise N. Mwangi verfasserin aut Nancy Mburu verfasserin aut Celestine Muteshi verfasserin aut Salome Okisa Muyale verfasserin aut Faith Mueni verfasserin aut Rosemary Mututa verfasserin aut Joyce Oketch verfasserin aut Orina Nyakina verfasserin aut Faith Njeru verfasserin aut Margaret Wanjiku Mwaura verfasserin aut Seline Kulubi verfasserin aut Susan Wanjala verfasserin aut Pauline Njeru verfasserin aut John Ollongo verfasserin aut Otieno George Obop verfasserin aut Jeska Kuya verfasserin aut Benjamin Tanui verfasserin aut Judith Onsongo verfasserin aut Peter Muigai verfasserin aut Arnest Namayi verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 5 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:5 https://doi.org/10.1136/bmjgh-2020-004475 kostenfrei https://doaj.org/article/0a0cfc4b105a43c7af5a4f96fc55bd9c kostenfrei https://gh.bmj.com/content/6/5/e004475.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 5 |
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10.1136/bmjgh-2020-004475 doi (DE-627)DOAJ019044275 (DE-599)DOAJ0a0cfc4b105a43c7af5a4f96fc55bd9c DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Grace Irimu verfasserin aut Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Medicine (General) Infectious and parasitic diseases Morris Ogero verfasserin aut George Mbevi verfasserin aut David Gathara verfasserin aut Samuel Akech verfasserin aut Jalemba Aluvaala verfasserin aut Ambrose Agweyu verfasserin aut Mercy Chepkirui verfasserin aut Sylvia Omoke verfasserin aut Emma Namulala verfasserin aut Juma Vitalis verfasserin aut Rachel Inginia verfasserin aut Grace Ochieng verfasserin aut Lydia Thuranira verfasserin aut Esther Njiru verfasserin aut Charles Nzioki verfasserin aut Caren Emadau verfasserin aut Christine Manyasi verfasserin aut Fred Were verfasserin aut Magdalene Kuria verfasserin aut Mary Waiyego verfasserin aut Beth Maina verfasserin aut Edith Gicheha verfasserin aut Joseph Nganga verfasserin aut Esther Mwangi verfasserin aut Esther Muthiani verfasserin aut Mary Nguri verfasserin aut Samuel Soita verfasserin aut Margaret Waweru verfasserin aut Alfred Wanjau verfasserin aut Caroline Mwangi verfasserin aut John Wainaina verfasserin aut Livingstone Mumelo verfasserin aut Nyumbile Bonface verfasserin aut Wagura Mwangi verfasserin aut Penina Mwangi verfasserin aut Felistus Makokha verfasserin aut Josephine Ojigo verfasserin aut Bernadette Lusweti verfasserin aut Amilia Ngoda verfasserin aut Dolphine Mochache verfasserin aut Jane Mbungu verfasserin aut Joan Baswetty verfasserin aut Josephine Aritho verfasserin aut Beatrice Njambi verfasserin aut Zainab Kioni verfasserin aut Lucy Kinyua verfasserin aut Alice Oguda verfasserin aut Loise N. Mwangi verfasserin aut Nancy Mburu verfasserin aut Celestine Muteshi verfasserin aut Salome Okisa Muyale verfasserin aut Faith Mueni verfasserin aut Rosemary Mututa verfasserin aut Joyce Oketch verfasserin aut Orina Nyakina verfasserin aut Faith Njeru verfasserin aut Margaret Wanjiku Mwaura verfasserin aut Seline Kulubi verfasserin aut Susan Wanjala verfasserin aut Pauline Njeru verfasserin aut John Ollongo verfasserin aut Otieno George Obop verfasserin aut Jeska Kuya verfasserin aut Benjamin Tanui verfasserin aut Judith Onsongo verfasserin aut Peter Muigai verfasserin aut Arnest Namayi verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 5 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:5 https://doi.org/10.1136/bmjgh-2020-004475 kostenfrei https://doaj.org/article/0a0cfc4b105a43c7af5a4f96fc55bd9c kostenfrei https://gh.bmj.com/content/6/5/e004475.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 5 |
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10.1136/bmjgh-2020-004475 doi (DE-627)DOAJ019044275 (DE-599)DOAJ0a0cfc4b105a43c7af5a4f96fc55bd9c DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Grace Irimu verfasserin aut Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Medicine (General) Infectious and parasitic diseases Morris Ogero verfasserin aut George Mbevi verfasserin aut David Gathara verfasserin aut Samuel Akech verfasserin aut Jalemba Aluvaala verfasserin aut Ambrose Agweyu verfasserin aut Mercy Chepkirui verfasserin aut Sylvia Omoke verfasserin aut Emma Namulala verfasserin aut Juma Vitalis verfasserin aut Rachel Inginia verfasserin aut Grace Ochieng verfasserin aut Lydia Thuranira verfasserin aut Esther Njiru verfasserin aut Charles Nzioki verfasserin aut Caren Emadau verfasserin aut Christine Manyasi verfasserin aut Fred Were verfasserin aut Magdalene Kuria verfasserin aut Mary Waiyego verfasserin aut Beth Maina verfasserin aut Edith Gicheha verfasserin aut Joseph Nganga verfasserin aut Esther Mwangi verfasserin aut Esther Muthiani verfasserin aut Mary Nguri verfasserin aut Samuel Soita verfasserin aut Margaret Waweru verfasserin aut Alfred Wanjau verfasserin aut Caroline Mwangi verfasserin aut John Wainaina verfasserin aut Livingstone Mumelo verfasserin aut Nyumbile Bonface verfasserin aut Wagura Mwangi verfasserin aut Penina Mwangi verfasserin aut Felistus Makokha verfasserin aut Josephine Ojigo verfasserin aut Bernadette Lusweti verfasserin aut Amilia Ngoda verfasserin aut Dolphine Mochache verfasserin aut Jane Mbungu verfasserin aut Joan Baswetty verfasserin aut Josephine Aritho verfasserin aut Beatrice Njambi verfasserin aut Zainab Kioni verfasserin aut Lucy Kinyua verfasserin aut Alice Oguda verfasserin aut Loise N. Mwangi verfasserin aut Nancy Mburu verfasserin aut Celestine Muteshi verfasserin aut Salome Okisa Muyale verfasserin aut Faith Mueni verfasserin aut Rosemary Mututa verfasserin aut Joyce Oketch verfasserin aut Orina Nyakina verfasserin aut Faith Njeru verfasserin aut Margaret Wanjiku Mwaura verfasserin aut Seline Kulubi verfasserin aut Susan Wanjala verfasserin aut Pauline Njeru verfasserin aut John Ollongo verfasserin aut Otieno George Obop verfasserin aut Jeska Kuya verfasserin aut Benjamin Tanui verfasserin aut Judith Onsongo verfasserin aut Peter Muigai verfasserin aut Arnest Namayi verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 5 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:5 https://doi.org/10.1136/bmjgh-2020-004475 kostenfrei https://doaj.org/article/0a0cfc4b105a43c7af5a4f96fc55bd9c kostenfrei https://gh.bmj.com/content/6/5/e004475.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 5 |
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10.1136/bmjgh-2020-004475 doi (DE-627)DOAJ019044275 (DE-599)DOAJ0a0cfc4b105a43c7af5a4f96fc55bd9c DE-627 ger DE-627 rakwb eng R5-920 RC109-216 Grace Irimu verfasserin aut Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier 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. Medicine (General) Infectious and parasitic diseases Morris Ogero verfasserin aut George Mbevi verfasserin aut David Gathara verfasserin aut Samuel Akech verfasserin aut Jalemba Aluvaala verfasserin aut Ambrose Agweyu verfasserin aut Mercy Chepkirui verfasserin aut Sylvia Omoke verfasserin aut Emma Namulala verfasserin aut Juma Vitalis verfasserin aut Rachel Inginia verfasserin aut Grace Ochieng verfasserin aut Lydia Thuranira verfasserin aut Esther Njiru verfasserin aut Charles Nzioki verfasserin aut Caren Emadau verfasserin aut Christine Manyasi verfasserin aut Fred Were verfasserin aut Magdalene Kuria verfasserin aut Mary Waiyego verfasserin aut Beth Maina verfasserin aut Edith Gicheha verfasserin aut Joseph Nganga verfasserin aut Esther Mwangi verfasserin aut Esther Muthiani verfasserin aut Mary Nguri verfasserin aut Samuel Soita verfasserin aut Margaret Waweru verfasserin aut Alfred Wanjau verfasserin aut Caroline Mwangi verfasserin aut John Wainaina verfasserin aut Livingstone Mumelo verfasserin aut Nyumbile Bonface verfasserin aut Wagura Mwangi verfasserin aut Penina Mwangi verfasserin aut Felistus Makokha verfasserin aut Josephine Ojigo verfasserin aut Bernadette Lusweti verfasserin aut Amilia Ngoda verfasserin aut Dolphine Mochache verfasserin aut Jane Mbungu verfasserin aut Joan Baswetty verfasserin aut Josephine Aritho verfasserin aut Beatrice Njambi verfasserin aut Zainab Kioni verfasserin aut Lucy Kinyua verfasserin aut Alice Oguda verfasserin aut Loise N. Mwangi verfasserin aut Nancy Mburu verfasserin aut Celestine Muteshi verfasserin aut Salome Okisa Muyale verfasserin aut Faith Mueni verfasserin aut Rosemary Mututa verfasserin aut Joyce Oketch verfasserin aut Orina Nyakina verfasserin aut Faith Njeru verfasserin aut Margaret Wanjiku Mwaura verfasserin aut Seline Kulubi verfasserin aut Susan Wanjala verfasserin aut Pauline Njeru verfasserin aut John Ollongo verfasserin aut Otieno George Obop verfasserin aut Jeska Kuya verfasserin aut Benjamin Tanui verfasserin aut Judith Onsongo verfasserin aut Peter Muigai verfasserin aut Arnest Namayi verfasserin aut In BMJ Global Health BMJ Publishing Group, 2018 6(2021), 5 (DE-627)85645365X (DE-600)2851843-3 20597908 nnns volume:6 year:2021 number:5 https://doi.org/10.1136/bmjgh-2020-004475 kostenfrei https://doaj.org/article/0a0cfc4b105a43c7af5a4f96fc55bd9c kostenfrei https://gh.bmj.com/content/6/5/e004475.full kostenfrei https://doaj.org/toc/2059-7908 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 6 2021 5 |
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Grace Irimu @@aut@@ Morris Ogero @@aut@@ George Mbevi @@aut@@ David Gathara @@aut@@ Samuel Akech @@aut@@ Jalemba Aluvaala @@aut@@ Ambrose Agweyu @@aut@@ Mercy Chepkirui @@aut@@ Sylvia Omoke @@aut@@ Emma Namulala @@aut@@ Juma Vitalis @@aut@@ Rachel Inginia @@aut@@ Grace Ochieng @@aut@@ Lydia Thuranira @@aut@@ Esther Njiru @@aut@@ Charles Nzioki @@aut@@ Caren Emadau @@aut@@ Christine Manyasi @@aut@@ Fred Were @@aut@@ Magdalene Kuria @@aut@@ Mary Waiyego @@aut@@ Beth Maina @@aut@@ Edith Gicheha @@aut@@ Joseph Nganga @@aut@@ Esther Mwangi @@aut@@ Esther Muthiani @@aut@@ Mary Nguri @@aut@@ Samuel Soita @@aut@@ Margaret Waweru @@aut@@ Alfred Wanjau @@aut@@ Caroline Mwangi @@aut@@ John Wainaina @@aut@@ Livingstone Mumelo @@aut@@ Nyumbile Bonface @@aut@@ Wagura Mwangi @@aut@@ Penina Mwangi @@aut@@ Felistus Makokha @@aut@@ Josephine Ojigo @@aut@@ Bernadette Lusweti @@aut@@ Amilia Ngoda @@aut@@ Dolphine Mochache @@aut@@ Jane Mbungu @@aut@@ Joan Baswetty @@aut@@ Josephine Aritho @@aut@@ Beatrice Njambi @@aut@@ Zainab Kioni @@aut@@ Lucy Kinyua @@aut@@ Alice Oguda @@aut@@ Loise N. Mwangi @@aut@@ Nancy Mburu @@aut@@ Celestine Muteshi @@aut@@ Salome Okisa Muyale @@aut@@ Faith Mueni @@aut@@ Rosemary Mututa @@aut@@ Joyce Oketch @@aut@@ Orina Nyakina @@aut@@ Faith Njeru @@aut@@ Margaret Wanjiku Mwaura @@aut@@ Seline Kulubi @@aut@@ Susan Wanjala @@aut@@ Pauline Njeru @@aut@@ John Ollongo @@aut@@ Otieno George Obop @@aut@@ Jeska Kuya @@aut@@ Benjamin Tanui @@aut@@ Judith Onsongo @@aut@@ Peter Muigai @@aut@@ Arnest Namayi @@aut@@ |
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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 (&gt;95%). 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Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
| abstract |
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. |
| abstractGer |
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. |
| abstract_unstemmed |
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. |
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| title_short |
Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study |
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https://doi.org/10.1136/bmjgh-2020-004475 https://doaj.org/article/0a0cfc4b105a43c7af5a4f96fc55bd9c https://gh.bmj.com/content/6/5/e004475.full https://doaj.org/toc/2059-7908 |
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Morris Ogero George Mbevi David Gathara Samuel Akech Jalemba Aluvaala Ambrose Agweyu Mercy Chepkirui Sylvia Omoke 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 |
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Morris Ogero George Mbevi David Gathara Samuel Akech Jalemba Aluvaala Ambrose Agweyu Mercy Chepkirui Sylvia Omoke 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 |
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10.1136/bmjgh-2020-004475 |
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2024-07-03T21:28:53.125Z |
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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 (&gt;95%). 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