ArticleBMC pediatrics2018
A retrospective study of neonatal case management and outcomes in rural Rwanda post implementation of a national neonatal care package for sick and small infants.
Article in BMC pediatrics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Quality of neonatal intensive care in Africa: a systematic review and meta-analysis.BMC health services research · 2026Pooled it
- A qualitative study to explore the experience of parents of newborns admitted to neonatal care unit in rural Rwanda.PloS one · 2021Trial
- Survive and Thrive: Outcomes of Children Enrolled in a Follow-Up Clinic for Small and Sick Newborns in Rural Rwanda.Healthcare (Basel, Switzerland) · 2024Article
- Factors associated with neonatal sepsis among neonates admitted in Kibungo Referral Hospital, Rwanda.Scientific reports · 2024Article
- The Journey Toward Establishing Inpatient Care for Small and Sick Newborns in Ethiopia, India, Malawi, and Rwanda.Global health, science and practice · 2023Article
- Case Management Improves Satisfaction, Anxiety, and Depression of Patients with Pregnancy Loss after In Vitro Fertilization and Embryo Transfer.Computational and mathematical methods in medicine · 2022Article
- Quality improvement strategies to improve inpatient management of small and sick newborns across All Babies Count supported hospitals in rural Rwanda.BMC pediatrics · 2021Article
- Admissions to a Low-Resource Neonatal Unit in Malawi Using a Mobile App and Dashboard: A 1-Year Digital Perinatal Outcome Audit.Frontiers in digital health · 2021Article
- Assessing factors associated with poor maternal mental health among mothers of children born small and sick at 24-47 months in rural Rwanda.BMC pregnancy and childbirth · 2020Observational
- Prevalence of perinatal asphyxia in East and Central Africa: systematic review and meta-analysis.Heliyon · 2020Review
- A low cost, re-usable electricity-free infant warmer: evaluation of safety, effectiveness and feasibiliy.Public health action · 2018Article
Corrections and comments
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite worldwide efforts to reduce neonatal mortality, 44% of under-five deaths occur in the first 28 days of life. The primary causes of neonatal death are preventable or treatable. This study describes the presentation, management and outcomes of hospitalized newborns admitted to the neonatal units of two rural district hospitals in Rwanda after the 2012 launch of a national neonatal protocol and standards.
methodsWe retrospectively reviewed routinely collected data for all neonates (0 to 28 days) admitted to the neonatal units at Rwinkwavu and Kirehe District Hospitals from January 1, 2013 to December 31, 2014. Data on demographic and clinical characteristics, clinical management, and outcomes were analyzed using median and interquartile ranges for continuous data and frequencies and proportions for categorical data. Clinical management and outcome variables were stratified by birth weight and differences between low birth weight (LBW) and normal birth weight (NBW) neonates were assessed using Fisher's exact or Wilcoxon rank-sum tests at the α = 0.05 significance level.
resultsA total of 1723 neonates were hospitalized over the two-year study period; 88.7% were admitted within the first 48 h of life, 58.4% were male, 53.8% had normal birth weight and 36.4% were born premature. Prematurity (27.8%), neonatal infection (23.6%) and asphyxia (20.2%) were the top three primary diagnoses. Per national protocol, vital signs were assessed every 3 h within the first 48 h for 82.6% of neonates (n = 965/1168) and 93.4% (n = 312/334) of neonates with infection received antibiotics. The overall mortality rate was 13.3% (n = 185/1386) and preterm/LBW infants had similar mortality rate to NBW infants (14.7 and 12.2% respectively, p = 0.131). The average length of stay in the neonatal unit was 5 days.
conclusionsOur results suggest that it is possible to provide specialized neonatal care for both LBW and NBW high-risk neonates in resource-limited settings. Despite implementation challenges, with the introduction of the neonatal care package and defined clinical standards these most vulnerable patients showed survival rates comparable to or higher than neighboring countries.
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