Evidence map›Paper›PMID 40069622›Full record

ArticleBMC pediatrics2025

Establishment of a neonatal nursery in a rural district hospital in Malawi: a retrospective review of neonatal outcomes in Neno District Hospital (2014-2021).

Mc Geofrey Mvula, Moses Banda Aron, Isaac Mphande, Lemekeza Namwali, Lawrence Nazimera, Martha Kusamba, Enoch Ndarama, Paul Sonenthal, Alden Hooper Blair, Kimberly Baltzell and 4 more

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In one paragraph

Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Mc Geofrey MvulaPartners in Health, P. O Box 56, Neno, Malawi. mvulamc@gmail.com.
Moses Banda AronPartners in Health, P. O Box 56, Neno, Malawi.
Isaac MphandePartners in Health, P. O Box 56, Neno, Malawi.
Lemekeza NamwaliNeno District Health Office, Ministry of Health, Neno, Malawi.
Lawrence NazimeraNeno District Health Office, Ministry of Health, Neno, Malawi.
Martha KusambaNeno District Health Office, Ministry of Health, Neno, Malawi.
Enoch NdaramaNeno District Health Office, Ministry of Health, Neno, Malawi.
Paul SonenthalPartners in Health, P. O Box 56, Neno, Malawi.
Alden Hooper BlairSan Francisco (UCSF) Institute for Global Health Sciences, University of California, San Francisco, CA, USA.
Kimberly BaltzellSan Francisco (UCSF) Institute for Global Health Sciences, University of California, San Francisco, CA, USA.
Fabien MunyanezaPartners in Health, P. O Box 56, Neno, Malawi.
Chiyembekezo KachimangaPartners in Health, P. O Box 56, Neno, Malawi.
Beatrice MatanjePartners in Health, P. O Box 56, Neno, Malawi.
Emilia ConnollyPartners in Health, P. O Box 56, Neno, Malawi.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite efforts to improve neonatal care worldwide, neonatal mortality rates in sub-Saharan Africa remain high. Adequate space, equipment, and staff are vital to improving mortality rates through high-quality care. We evaluated the impact of a district-level neonatal special care nursery over seven years at Neno District Hospital, Malawi.

methodsWe conducted a retrospective cohort study to measure the neonatal outcomes in the neonatal special care nursery before nursery establishment (study period I, 2014-2015), following the establishment of a small nursery (study period II, 2016-2018), then with a transition to a larger nursery (study period III, 2019-2021). We extracted data from the neonatal registers and employed descriptive statistics and chi-square tests to compare the overall neonatal outcomes between study periods. We performed logistic regression to isolate factors associated with neonates alive at discharge.

resultsOf the 1366 neonates observed over the entire study period, the three primary admission diagnoses were birth asphyxia (30.1%), sepsis (29.0%), and prematurity (20.9%). The proportion of neonates discharged alive increased from 61.9% to 74.3% and then 87.6% in study periods I, II, and III, respectively. Neonates admitted during study periods II and III were over two and five times more likely to be discharged alive than neonates admitted during study period I in multivariate analysis controlling for sex (SPII aOR = 2.42; 95% CI: 1.43-4.08; SPIII aOR = 5.32; 95% CI: 3.13-8.98; p < 0.001). There was no difference in being discharged alive for neonates admitted with prematurity compared to birth asphyxia (aOR 0.87; 95% CI: 0.51-.151) but neonates admitted with sepsis were over two times more likely to be discharged alive than birth asphyxia (aOR = 2.64; 95% CI: 1.67-4.29). Neonates admitted with a birth weight of

conclusionsThe establishment and systems strengthening of a neonatal nursery at Neno District Hospital resulted in a significant increase of neonates discharged alive from the neonatal special care nursery. A multidimensional approach to ensuring resource inputs and ongoing strengthening efforts in Malawi is critical to decreasing neonatal mortality within the special care nursery.

Indexed as

Hospitals, DistrictHospitals, RuralNurseries, HospitalAsphyxia NeonatorumFemaleHumansInfantInfant MortalityInfant, NewbornInfant, PrematureMalawiMaleRetrospective StudiesSepsisBirth asphyxiaEquipmentNeonatal nurseryNeonatesSepsis and prematuritySpaceStaff

Identifiers

PMID40069622
PMCPMC11895299

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.