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- Title
Delays in healthcare delivery to sick neonates in Enugu South-East Nigeria: an analysis of causes and effects.
- Authors
Ekwochi, Uchenna; Ndu, Ikenna K.; Osuorah, Chidiebere D. I.; Onah, Kenechi S.; Obuoha, Ejike; Odetunde, Odutola I.; Nwokoye, Ikenna; Obumneme-Anyim, Nnenne I.; Okeke, Ifeyinwa B.; Amadi, Ogechukwu F.
- Abstract
Background In most parts of the world, neonatal mortality rates have shown a slower decline when compared with under-5 mortality decline. A sick newborn can die within minutes if there is a delay in presentation, thus early diagnosis and treatment are essential for the survival of a critically ill newborn. This study investigated factors responsible for delays in healthcare services for the sick newborn and maternal socio-demographic variables that influence these delays in Enugu, South-East Nigeria. Methods This was a community-based descriptive study. A total of 376 respondents were randomly selected from 4 of the 17 local government areas of Enugu State. Mothers and/or caregivers that were nursing or had nursed a child in the previous 2 years were enrolled. Self-reported data on delays encountered during healthcare for sick newborn were collected using pretested structured questionnaire. Chi-square and multivariate logistic regression were used to determine the association between causes of delays in newborn healthcare services, maternal socio-demographics and relationships with newborn mortality. Results Delays in reaching healthcare facilities accounted for the most common delays encountered by respondents, 78.0%, in this study, followed by delays at household level, 24.2% and delays at health facility level 16.0% (P = 0.000). Mothers with knowledge of ≥3 WHO recognized danger signs compared with those with ≤2 were significantly less likely to delay at household (level 1: 40.7 versus 59.3%) (P= 0.017) and reaching healthcare service (level 2: 19.9 versus 80.1 %)(P= 0.028). Delays at health facility level (level 3) occurred more at tertiary health facilities (59.0%), secondary health facilities (39.1 %)and primary healthcare facilities (19.7%) compared with private health facilities (13.5%) (P-0.000). Conclusions Delays in seeking healthcare at all levels especially those related to transporting the sick newborn to the hospital area contributor to newborn mortality in Nigeria. Improving access to healthcare could potentially reduce mortality in the sick newborn.
- Publication
Journal of Public Health, 2016, Vol 38, Issue 2, pe171
- ISSN
1741-3842
- Publication type
Article
- DOI
10.1093/pubmed/fdv092