ArticleBMJ open2022
Impact of secondary and tertiary neonatal interventions on neonatal mortality in a low- resource limited setting hospital in Uganda: a retrospective study.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 4 citations in OpenAlex.
- Health Workers' Knowledge and Practice of Developmentally Supportive Care for Premature Infants in Four Ugandan Neonatal Units: A Cross-Sectional Study.Health science reports · 2026Article
- Oxygen blenders for prevention of retinopathy of prematurity are highly cost-effective in Uganda.Frontiers in medicine · 2026Article
- 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
- 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
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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
objectiveTo assess the impact of secondary and tertiary level neonatal interventions on neonatal mortality over a period of 11 years.
designInterrupted time series analysis.
settingNsambya Hospital, Uganda.
interventionsNeonatal secondary interventions (phase I, 2007-2014) and tertiary level interventions (phase II, 2015-2020).
participantsNeonates. PRIMARY AND SECONDARY OUTCOME MEASURES: Primary outcome: neonatal mortality. SECONDARY OUTCOME: case fatality rate (CFR) for prematurity, neonatal sepsis and asphyxia.
resultsDuring the study period, a total of 25 316 neonates were admitted, of which 1853 (7.3%) died. The average inpatient mortality reduced from 8.2% during phase I to 5.7% during phase II (p=0.001). The CFR for prematurity reduced from 16.2% to 9.2% (p=0.001). There was a trend in reduction for the CFR of perinatal asphyxia from 14.9% to 13.0% (p=0.34). The CFR for sepsis had a more than a twofold increase (3%-6.8% p=0.001) between phase I and phase II.
conclusionImplementation of secondary and tertiary neonatal care in resource-limited settings is feasible. This study shows that these interventions can significantly reduce the neonatal mortality, with the largest impact seen in the reduction of deaths from perinatal asphyxia and prematurity. An increase in sepsis related deaths was observed, suggesting emphasis on infection control is key.
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