Factors Associated With Neonatal Deaths In Katima Mulilo State Hospital

ABSTRACT

The neonatal mortality rate is the most essential indicator of obstetric care as well as overall socio-economic development in any given country. It is also a sensitive indicator of the impact of programme intervention and for monitoring changes in quality care (MOHSS, 1996: 2).

The Health Information System (HIS) at Katima Mulilo State Hospital reported an increase in neonatal deaths of 8/1000 live births (0,8%) in 2001 to 39/1000 live births (3,9%)in 2002. Based on this problem, factors associated with neonatal deaths were investigated in an effort to improve mother and child health in Katima Mulilo Hospital.

In reviewing the literature, factors such as prematurity, low birth weight, infection, high parity/gravida, maternal age, birth intervals, hypothermia, lack of equipment, asphyxia and some obstetric related conditions such as placental pathologies, pregnancy-induced hypertension and birth injuries were identified. After applicable validation, these factors were also included in the instrument construction of this study.

A comparative, descriptive and retrospective study was conducted from cases and controls selected from the total population. Cases referred to mothers and their diseased neonates, while controls referred to mothers and their surviving neonates. Some statistically significant differences were found between the case group and the

control group with regard to certain variables that could be regarded as factors associated with neonatal deaths.

Recommendations that were formulated based on this research report include emphasis on improved maternal and child health education, in-service training for registered nurses, regular audits of patient records and discussion of audit results. In addition it is proposed that the in-service training of traditional birth attendants be enhanced. It is recommended that these traditional midwives be instructed in the early detection of complications and the correct referral to health facilities. Extension of outreach services to all corners of the region should be implemented. Revision of national policy guidelines with regard to treatment protocols is also proposed. Consideration should also be given to the establishment of hospital facilities to improve the care of premature babies, which should accommodate mothers for Kangaroo Mother Care.