ArticleBMC pregnancy and childbirth2016
Reduced neonatal mortality in a regional hospital in Mozambique linked to a Quality Improvement intervention.
Article in BMC pregnancy and childbirth, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 3 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Evidence-based interventions to reduce mortality among preterm and low-birthweight neonates in low-income and middle-income countries: a systematic review and meta-analysis.BMJ global health · 2021Pooled it
- Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review.Journal of global health · 2021Pooled it
- Quality improvement initiatives for hospitalised small and sick newborns in low- and middle-income countries: a systematic review.Implementation science : IS · 2018Pooled it
- Electrification and specialist training associated with decreased neonatal mortality and increased admissions in Sierra Leone.Acta paediatrica (Oslo, Norway : 1992) · 2025Observational
- Article
- Assessment of Neonatal Mortality and Associated Hospital-Related Factors in Healthcare Facilities Within Sunyani and Sunyani West Municipal Assemblies in Bono Region, Ghana.Health services insights · 2024Article
- Trends in Neonatal Mortality at Princess Marie Louise Children's Hospital, Accra, and the Newborn Strategic Plan: Implications for Reducing Mortality in Hospital and the Community.Children (Basel, Switzerland) · 2023Article
- Outborn newborns drive birth asphyxia mortality rates-An 8 year analysis at a rural level two nursery in Uganda.PLOS global public health · 2023Article
- Born too soon in a resource-limited setting: A 10-year mixed methods review of a special care baby unit for refugees and migrants on the Myanmar-Thailand border.Frontiers in public health · 2023Article
- Impact of Quality Improvement Bundle on Neonatal Mortality in a District Hospital in Tanzania.Children (Basel, Switzerland) · 2022Article
- Infection prevention and care bundles addressing health care-associated infections in neonatal care in low-middle income countries: a scoping review.EClinicalMedicine · 2022Article
- Oxygen management among infants in neonatal units in sub-Saharan Africa: a cross-sectional survey.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Quality improvement strategies to improve inpatient management of small and sick newborns across All Babies Count supported hospitals in rural Rwanda.BMC pediatrics · 2021Article
- Non-linear association between admission temperature and neonatal mortality in a low-resource setting.Scientific reports · 2020Article
- Risk factors for mortality among neonates admitted to a special care unit in a low-resource setting.BMC pregnancy and childbirth · 2020Observational
- Impact of temperature change from admission to day one on neonatal mortality in a low-resource setting.BMC pregnancy and childbirth · 2020Observational
- Article
- Saving Mothers, Giving Life Approach for Strengthening Health Systems to Reduce Maternal and Newborn Deaths in 7 Scale-up Districts in Northern Uganda.Global health, science and practice · 2019Article
- Developing and implementing an interventional bundle to reduce mortality from gastroschisis in low-resource settings.Wellcome open research · 2019Article
- Staged implementation of a two-tiered hospital-based neonatal care package in a resource-limited setting in Eastern Uganda.BMJ global health · 2018Review
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8 authors.
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Abstract
backgroundNeonatal mortality remains a serious health issue especially in low resource countries, where 99% of neonatal deaths occur. Doctors with Africa CUAMM is an Italian non-governmental organization in the field of healthcare that has been working in Africa since 1955. In Mozambique, at the Central Beira Hospital (CBH), it has a project with the aim of supporting the neonatal intensive care unit (NICU) and the Obstetrical Department of the CBH through a multi-level intervention. Our aim was to evaluate the effectiveness of CUAMM continuous Quality Improvement intervention in terms of reduction of the overall neonatal mortality rate in the NICU of CBH.
methodsA baseline analysis was performed in order to assess the actual standard of neonatal care. Subsequently, the intervention was focused on three main areas: infrastructure, equipment and clinical protocols improvement. A retrospective pre- (2013)/post- (2014) implementation analysis of clinical outcomes was performed.
resultsTotal population included 4,276 newborns, 2,118 (50%) born in 2013 and 2158 (50%) born after implementation. Baseline characteristics of the two groups were similar apart from a higher incidence of outborn neonates (33% vs 30%, p = 0.02) and a lower incidence of Apgar score < 7 at 5 min (37% vs 43%, p < 0.01). The rates of admissions for asphyxia (22% vs 30%), sepsis (4% vs 7%) and prematurity (18% vs 28%) increased between the two study period. Mortality rate for each of these causes decreased from before to after the implementation: asphyxia (34% vs 19%, p < 0.01), sepsis (39% vs 28%, p = 0.06) and prematurity (43% vs 33%, p < 0.01).
conclusionWe found a reduction in mortality rate among newborns admitted to CBH's NICU after the first year of CUAMM intervention. Most of this reduction can be attributed to the decrease in deaths for asphyxia, sepsis and prematurity. A Quality Improvement intervention based on infrastructural, equipment and clinical objectives was associated with a reduction of neonatal mortality rate in a low-resource NICU.
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