Improving the quality of neonatal data capture and clinical care at a tertiary-care hospital in Uganda through enhanced surveillance, training and mentorship
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Date
2020
Journal Title
Journal ISSN
Volume Title
Publisher
Paediatrics and International Child Health
Abstract
Accurate documentation of neonatal morbidity and mortality is limited in
many countries in sub-Saharan Africa. This project aimed to establish a surveillance system
for neonatal conditions as an approach to improving the quality of neonatal care.
Methods: A systematic data capture and surveillance system was established at Jinja Regional
Referral Hospital, Uganda using a standardised neonatal medical record form which collected
detailed individual patient level data. Additionally, training and mentorship were conducted
and basic equipment was provided.
Results: A total of 4178 neonates were hospitalised from July 2014 to December 2016.
Median (IQR) age on admission was one day (1–3) and 48.0% (1851/3859) were male.
Median (IQR) duration of hospitalisation was 17 days (IQR 10–40) and the longest duration
of hospitalisation was 47 days (IQR 41–58). The majority were referrals from government
health facilities (54.4%, 2012/3699), though 30.6% (1123/3669) presented as self-referrals.
Septicaemia (44.9%, 1962/4371), prematurity (21.0%, 917/4371) and birth asphyxia (19.1%,
833/4371) were the most common diagnoses. The overall mortality was 13.8% (577/4178) and
the commonest causes of death included septicaemia (26.9%, 155/577), prematurity (24.3%,
140/577), birth asphyxia (21.0%, 121/577), hypothermia (9.9%, 57/577) and respiratory distress
(8.0%, 46/577). The majority of deaths (51.5%, 297/577) occurred within the first 24 h of
hospitalisation although a significant proportion of deaths also occurred after 7 days of
hospitalisation (24.1%, 139/577). A modest decrease in mortality and improvement in clinical
outcome were observed.
Conclusion: Improvement in neonatal data capture and quality of care was observed following
establishment of an enhanced surveillance system, training and mentorship.
Description
Keywords
Neonates, Quality of care, Morbidity, Mortality, Quality improvement
Citation
Jane Achan, Humphrey Wanzira, Arthur Mpimbaza, Daniel Tumwine, Sophie Namasopo, Harriet Nambuya, Asadu Serwanga & Rebecca Nantanda (2019): Improving the quality of neonatal data capture and clinical care at a tertiary-care hospital in Uganda through enhanced surveillance, training and mentorship, Paediatrics and International Child Health, DOI: 10.1080/20469047.2019.1638131