Abstract:
Background: Very early neonatal mortality (deaths within 24 hours after birth) is a major contributor to death among children under 5 years old in low and middle income countries. This particular study was conducted to determine the health facility-based factors and maternal characteristics that influence very early neonatal mortality rate (VENMR), the level of knowledge of nurses, midwives, and doctors on neonatal care and resuscitation, the practices of nurses, midwives, and doctors that may contribute to very early neonatal deaths, the gaps in equipment and logistics that may contribute to very early neonatal mortality, and to identify the maternal characteristics that influence very early neonatal mortality in Koforidua Regional Hospital. Methods: In all 811 delivery records were reviewed at Koforidua Regional Hospital for a period of 2years, January 2013 to December, 2014 using data extraction sheets. The maternal characteristics and causes of death were extracted from the delivery register, and admission and discharge (A &D) books. Semi-structured questionnaires were also administered to 4 doctors, 13 midwives, and 7 nurses who work in the labour ward and NICU.
Results: The VENMR was 9 per 1000 live births. Midwives had the highest average knowledge on newborn care and resuscitation (70.8%) but the difference was not significant, infection prevention protocols and good practices were said to be done from the responses. There was 12.5% gap in access to Infant face Masks sizes (0, 1,2). Doctors had the highest number of logistics and equipment available to them. Multiparity reduced the odds of very early neonatal death by 30%.Number of previous child deaths was 34.75 times the odds of dying within the first 24 hours after birth than those without previous child deaths. Mothers
with a previous neonatal death had about 8 times the odds of having a very early neonatal death as compared to those without history of neonatal death. Conclusion: VENMR at Koforidua regional hospital is low as compared to the National figure of Ghana but high in comparison with other studies. There is low knowledge on neonatal care and resuscitation among the different cadre of staff in the NICU and labour ward. Maternal characteristics have a significant contribution to very early neonatal outcome.
