scholarly journals Prevalence of neonatal near miss and associated factors in Nepal: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rajbanshi Sushma ◽  
Mohd Noor Norhayati ◽  
Nik Hussain Nik Hazlina

Abstract Background The rate of neonatal mortality has declined but lesser than the infant mortality rate and remains a major public health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 h after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and gestational age were enrolled. Key inclusion criteria were pragmatic and management markers of NNM and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0. Results One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI) 2.07–9.84) and no formal education (aOR 2.16; 95% CI 1.12–4.14) had a positive association with NNM, while multiparity (aOR 0.52; 95% CI 0.32–0.86) and caesarean section (aOR 0.44; 95% CI 0.19–0.99) had negative associations with NNM. Conclusions Maternal characteristics and complications were associated with NNM. Healthcare providers should be aware of the impact of obstetric factors on newborn health and provide earlier interventions to pregnant women, thus increasing survival chances of newborns.

2021 ◽  
Author(s):  
Sushma Rajbanshi ◽  
Norhayati Mohd Noor ◽  
Nik Hazlina Nik Hussain

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not significantly declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted in Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. Prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (aOR) 4.52; 95% confidence interval (CI): 2.07–9.84), no education (aOR 2.16; 95% CI 1.12–4.14), multiparity (aOR 0.52; 95% CI 0.32–0.86), and caesarean section (aOR 0.44: 95% CI 0.19–0.99) were associated with NNM. Conclusions: Prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Women in referral hospitals should have safer access to caesarean section and be prepared for NICU intervention to save mothers and their newborns.


2020 ◽  
Author(s):  
Sushma Rajbanshi ◽  
Norhayati Mohd Noor ◽  
Nik Hazlina Nik Hussain

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in the low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours after birth and the early neonatal period. Neonatal near miss (NNM) is an emerging concept similar to that of maternal near miss. NNM events occur three to eight times more often than the neonatal deaths. The objective of this study was to establish the prevalence of NNM and identify its associated factors. Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Morang district, Nepal. Neonates and their mothers of unspecified maternal age and number of gestational weeks were enrolled. The key inclusion criterion was the pragmatic and management markers of NNM, and admission of newborn infants to the neonatal intensive care unit (NICU) in Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size of 1,000 newborn infants was reached. Simple and multiple logistic regression analysis was performed using SPSS® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Severe maternal morbidity (adjusted odds ratio (AOR): 4.51, 95% confidence interval (CI): 2.07–9.84), maternal secondary (AOR: 0.46, 95% CI: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), and caesarean section (AOR: 0.48, 95% CI: 0.19–0.99) were associated with NNM. Conclusions: The prevalence of NNM in Nepal was 7.9%. Mothers’ obstetric factors, maternal complications and education were associated with NNM. Referral hospitals should have safer access to caesarean section and be prepared to offer NICU intervention to save mothers and their newborns.


2020 ◽  
Author(s):  
Sushma Rajbanshi ◽  
Norhayati Mohd Noor ◽  
Nik Hazlina Nik Hussain

Abstract Background: Unlike the infant mortality rate, the rate of neonatal mortality has not declined and remains a major health challenge in low- and middle-income countries. There is an urgent need to focus on newborn care, especially during the first 24 hours of birth and the early neonatal period. Determining which factors contribute to neonatal near miss (NNM) can be used to assess health care quality and identify factors capable of correction in the healthcare system to improve neonatal care. Thus, the objective of the current study was to establish the prevalence of NNM and identify its associated factors.Methods: A hospital-based cross-sectional study was conducted at Koshi Hospital, Nepal. Neonates and their mothers (unspecified maternal age and number of gestational weeks) were enrolled. The key inclusion criterion was the admission of newborn infants to the neonatal intensive care unit at Koshi Hospital. Non-Nepali citizens were excluded. Consecutive sampling was used until the required sample size (i.e., 1,000 newborn infants) was reached. Simple and multiple logistic regression analysis was performed using SPSS ® version 24.0.Results: One thousand respondents were recruited. The prevalence of NNM was 79 per 1,000 live births. Maternal secondary (adjusted odds ratio (AOR]: 0.46, 95% confidence interval (CI]: 0.24–0.88) and tertiary education (AOR: 0.18, 95% CI: 0.05–0.56), multiparity (AOR: 0.52, 95% CI: 0.39–0.86), Caesarean section (AOR: 0.48, 95% CI: 0.19–0.99), and severe maternal morbidity (AOR: 4.51, 95% CI: 2.07–9.84) were significantly associated with NNM.Conclusions: Parity, severe maternal morbidity, mode of delivery, and maternal education were significantly associated with NNM. Healthcare workers should be aware of the impact of obstetric factors so that earlier interventions, especially the Caesarean section, can be exercised.


2020 ◽  
Author(s):  
Anteneh Tekola Fikrie ◽  
Genet Ake Baye ◽  
Elias Hadona Amaje ◽  
Kebede Tefera

Abstract Background: Neonatal near miss is a neonate who nearly died but survived from a severe complication occurred during pregnancy, birth or within 0-28 days of extra-uterine life. However, there is no available data that quantifies the magnitude of neonatal near miss in Ethiopia where there is high prevalence of neonatal mortality. Therefore, this study is designed to provide information about the magnitude and associated factors of neonatal near miss among women who give a live birth at Hawassa City Governmental hospitals, 2019. Methods: A facility based cross-sectional study design was conducted on 604 mothers who gave live neonates at Adare General Hospital and Hawassa University Comprehensive and Specialized Hospital from May 9, 2019 to June 7, 2019. Face to face interviewer administered structured questionnaire with a supplementation of maternal and neonatal medical records with checklists were used to collect the data. Data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Descriptive statistics was run and the data were presented using frequency tables and figure. The bi-variable and multivariable logistic regression was used to identify the possible factors of neonatal near miss. Finally, Adjusted Odds Ratio and 95% Confidence Intervals were used to declare statsticall significance. Result Among all 604 selected live births an overall proportion of Neonatal Near Misses (NNM) cases, 202 (33.4 %;) (95% CI: 29.7%-37.1%) was obtained. Respiratory distress 158 (94%) and infection or sepsis 138 (84%) were found to be the leading causes of NNM cases in our study. Employed (AOR = 3.05, 95% CI: 1.46- 6.44), Pregnancy induced Hypertension (AOR = 0.43, 95%CI: 0.27-0.69) and Cesarean Section (AOR=0.49; 95%CI: 0.33-0.71) were significantly associated with neonatal near miss. Conclusion: This study revealed relatively high prevalence of neonatal near miss in the study areas. Employed women, pregnancy induced hypertension and cesarean section mode of delivery were found to be independent factors affecting the prevalence of NNM cases. Therefore, HUCSH and Adare general Hospitals should focus on proving quality antenatal care and prevention of occupational related problems among pregnant women.


PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251609
Author(s):  
Merertu Wondimu ◽  
Fikadu Balcha ◽  
Girma Bacha ◽  
Aklilu Habte

Background Neonates with severe complications at birth or during the neonatal period who nearly died but survived constitute neonatal near miss (NNM) cases. Identifying NNM cases and correcting contributing factors are of the utmost importance to get relevant controls for neonatal deaths. However, limited studies are assessing the prevalence of NNM and associated factors with NNM cases in Ethiopia. So, this study is aimed at assessing the magnitude of neonatal near miss and associated factors among live births in public hospitals of Jimma zone, southwest Ethiopia, 2020. Methods A facility-based cross-sectional study was conducted among 260 neonates from April 1–30 / 2020. Face to face interviewer-administered structured questionnaire was used to collect data from the mothers and a standard checklist was used for their neonates. The data was encoded and entered into Epi-Data version 4.2 and exported to SPSS version 23 for analysis. Independent variables with marginal associations (p-value <0.25) in the bivariable analysis were eligible for multivariable logistic regression analysis to detect an association with outcome variables. Finally, adjusted odds ratios (AOR) with 95% CI were used to estimate the strength of associations, and statistical significance was declared at a p-value < 0.05. Result The magnitude of NNM was 26.7% with [95%CI: 21.6–32.5]. Hypertension during pregnancy [AOR: 3.4; 95%CI: 1.32–8.88], mode of delivery [AOR: 3.32; 95%CI: 1.48–7.45], Obstructed labor [AOR: 2.95; 95%CI: 1.32–6.45] and non-vertex fetal presentation during delivery [AOR: 4.61; 95%CI: 2.16–9.84] were identified as significantly predictors of NNM. Conclusion and recommendation Over a quarter of the neonates were with NNM cases, which is relatively higher than the report of studies done in other countries. Hypertension during pregnancy, cesarean delivery, prolonged labor, and non-vertex fetal presentation were all found to increase the likelihood of NNM. Therefore, concerted efforts are needed from local health planners and health care providers to improve maternal health care services especially in early identification of the complications and taking appropriate management.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anteneh Fikrie Tekola ◽  
Genet Baye ◽  
Elias Amaje ◽  
Kebede Tefera

Abstract Background Neonatal near miss is a neonate who nearly died but survived from a severe complication occurred during pregnancy, birth or within 0–28 days of extra-uterine life. However, there is no available data that quantifies the magnitude of neonatal near miss (NNM) in Ethiopia where there is high prevalence of neonatal mortality. Therefore, this study is designed to provide information about the magnitude and associated factors of neonatal near miss among women who give a live birth at Hawassa City Governmental hospitals, 2019. Methods A facility based cross-sectional study design was conducted on 604 mothers who gave live neonates at Adare General Hospital and Hawassa University Comprehensive and Specialized Hospital from May 9, 2019 to June 7, 2019. Face to face interviewer administered structured questionnaire with a supplementation of maternal and neonatal medical records with checklists were used to collect the data. Data were coded and entered in to Epi data version 3.1 and then exported to the Statistical Package for Social Science IBM version 25 for analysis. Descriptive statistics was run and the data were presented using frequency tables and figure. The bi-variable and multivariable logistic regression was used to identify the possible factors of neonatal near miss. Finally, Adjusted Odds Ratio and 95% Confidence Intervals were used to declare statsticall significance. Result Among all 604 selected live births an overall proportion of NNM cases, 202 (33.4%) (95% CI: 29.7–37.1%) was obtained at Hawassa City Government Hospitals. Respiratory distress 158 (94%) and infection or sepsis 138 (84%) were found to be the leading causes of NNM cases in our study. Governmental and non-governmental employed mother (AOR = 3.05, 95% CI: 1.46–6.44) and Cesarean Section delivery (AOR = 1.89, (95% CI: 1.25–2.83)) were positively significantly associated with neonatal near miss. Whereas, pregnancy induced Hypertension (AOR = 0.43, 95%CI: 0.27–0.69) was negatively associated with neonatal near miss. Conclusion This study revealed relatively high prevalence of NNM in the study areas. Employed women, pregnancy induced hypertension and cesarean section mode of delivery were found to be independent factors affecting the prevalence of NNM cases. Therefore, HUCSH and Adare general Hospitals should focus on proving quality antenatal care and prevention of occupational related problems among pregnant women.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Enguday Tirfeneh Gebeyehu ◽  
Mengesha Srahbzu Biresaw

Introduction. The impact of alcohol use among adolescents is multidisciplinary and affects the adolescent’s academic performance, precipitates with sexually transmitted infections or psychiatric disorders, and disturbs the social domain of adolescents. Therefore, this study aimed to assess the prevalence and associated factors of alcohol use among adolescents aged 15–19 years at the governmental high schools of Aksum Town, Tigray, Ethiopia, in 2019. Methods. A facility-based cross-sectional study was conducted from 1 to 30 January 2019 at Aksum town high school. Alcohol use was assessed by asking the question “have you used at least one of the alcoholic beverages in the last three months for nonmedical purposes?” Study participants were selected using a simple random sampling technique. Data were collected with face-to-face interview and were analyzed using the Statistical Package for the Social Sciences version 22. Bivariate and multivariate logistic regressions were used to see the association between alcohol use and associated factors. Adjusted odds ratio at a p value < 0.05 with a 95% confidence interval was taken to declare the statistical significance of variables. Result. About 633 adolescents aged 15–19 years were addressed with a response rate of 99.7%. Prevalence of alcohol use was found to be 39.7% [95% CI (35.7, 43.6)]. Being male [AOR = 1.80; 95% CI (1.24, 2.60)], fathers’ educational status 1–8 grades [AOR = 2.98; 95% CI (1.60, 5.53)], fathers’ occupation farming [AOR = 4.24; 95% CI (2.038.85)], experienced parental neglect [AOR = 1.75; 95% CI (1.20, 2.55)], strong social support [AOR = 1.79; 95% CI (1.11, 2.87)], and family size of greater than five [AOR = 2.03; 95%CI (1.39, 2.97)] were factors identified to be significantly associated with alcohol use among adolescents aged 15–19 years. Conclusion. In the current study, the prevalence of alcohol use is found to be high when compared to other populations. A strong association has been found between alcohol use and lower paternal educational status and farming as an occupation of parents. There should be a regular awareness creation program for parents with lower education about the devastating effects of alcohol on adolescents.


2020 ◽  
Author(s):  
Tsegaye Adane Birhan ◽  
Walelegn Worku ◽  
Jember Azanaw ◽  
Lamrot Yohannes

Abstract Background: Globally, khat chewing practice becoming an alarming and common among the youth generation especially in higher educational institutions. It may also leads to frequent misbehavior, poor academic performance and memory impairment among students. This study aimed to determine the prevalence of khat chewing and associated factors among medical students in University of Gondar, Northwest Ethiopia, 2019.Method: An institution-based cross-sectional study was employed on 422 medical students. Data were collected using a self-administered questionnaire and analyzed using SPSS 20 software. Stratified followed by random sampling was employed to select the samples. Multivariable logistic regression model was fitted to identify the predictors. P ≤ 0.05 was used to select statistically significant factors.Result: The current prevalence of khat chewing among medical students was 21.5%. The odds of khat chewing was higher among males [AOR=3.353; 95%CI (1.460-7.701)], Muslims [AOR=6.390; 95%CI (1.903-21.460)], fifth and six year students [AOR= 3.391; 95%CI (1.354-8.488)], smokers [AOR=5.081; 95%CI (1.898-13.601)], alcohol users [AOR=4.872; 95%CI (2.094-11.332)], students who had khat chewer close friends [AOR=30.645; 95%CI (12.261-76.589)].Conclusion: Since a significant proportion of students chew khat, continuous awareness creation on the impact of khat chewing and counseling services are recommended.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037792
Author(s):  
Tsegaye Gebremedhin ◽  
Asmamaw Atnafu ◽  
Endalkachew Dellie

ObjectiveThe community-based newborn care (CBNC) is a newborn care package along the maternal and newborn health continuum of care that has been implemented at the community level in Ethiopia. The utilisation which might be affected by several factors has not been well assessed. Thus, this study aimed to examine the utilisation of CBNC and associated factors among women who delivered recently in Geze Gofa rural district, south Ethiopia.DesignCross-sectional study.SettingCommunity-based.ParticipantsThree-hundred seventy-one women who had their newborns recently were randomly selected. Then, they were interviewed at their places using an interviewer-administered structured questionnaire.MethodsA binary logistic regression analysis was done. In the multivariable logistic regression analysis, a p value of <0.05 and adjusted OR (AOR) with 95% CI were used to identify factors statistically associated with CBNC utilisation.OutcomesCBNC utilisation.ResultsThe findings showed that the overall utilisation of CBNC by women who delivered recently with their newborns was 37.5% (95% CI: 32.6 to 42.6). Factors associated with the utilisation of CBNC included women who attended elementary school (AOR: 1.76, 95% CI: 1.01 to 3.07), college and above (AOR: 3.71, 95% CI: 1.12 to 12.24), farmer women (AOR: 0.35, 95% CI: 0.16 to 0.79), women in the lowest (AOR: 3.76, 95% CI: 1.65 to 8.54) and middle quantile of wealth status (AOR: 1.96, 95% CI: 1.01 to 3.76), and those whose preference was visiting hospital only when they faced any signs of danger (AOR: 0.29, 95% CI: 0.11 to 0.78).ConclusionThe use of the CBNC programme in the study area was surprisingly low. To increase utilisation and potentially improve the outcomes of these neonates, we need to increase awareness at community levels, make convenient arrangements and increase the availability of services at nearby health facilities that are essential to improve the uptake of CBNC in the rural district.


Author(s):  
Jungwon Cho ◽  
Seungyeon Kim ◽  
Sangyoon Shin ◽  
Hyejin Yoo ◽  
Gi Hyue Park ◽  
...  

Studies have documented the impact of various types of health care information technology (HIT) on patient outcomes. However, literature on the HIT products is largely for outpatients and little is known about those for hospitalized patients. In 2014, a Korean hospital developed an inpatient portal known as the Smart Bedside Station (SBS). A retrospective cross-sectional study was conducted to evaluate the associated factors for accessing the medication view menu (Today’s Medication) on the SBS using data from October 2018 through September 2019. A root cause analysis with expert review was conducted to identify additional barriers for accessing the medication view menu. Approximately 92.58% of the study population accessed the SBS at least once during their hospital stay. However, 99.20% of accessed patients used the SBS for entertainment purposes (e.g., television) and 40.16% viewed the medication information. Younger age, higher education, and certain jobs were significant associated factors for accessing the medication information. In conclusion, this study revealed strong associations between accessing the medication view menu on the SBS and a number of associated factors. Based on the results, further research is warranted to suggest new items to access the medication view menu by hospitalized patients.


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