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International Journal of Pediatrics
Volume 2014 (2014), Article ID 986716, 11 pages
http://dx.doi.org/10.1155/2014/986716
Research Article

Challenges and Frugal Remedies for Lowering Facility Based Neonatal Mortality and Morbidity: A Comparative Study

1Department of Bioengineering, Imperial College London, South Kensington Campus, SW7 2AZ, UK
2Departments of Community Health and Paediatrics, Lagos University Teaching Hospital, PMB 12003, Lagos 101001, Nigeria
3Department of Paediatrics, University of Abuja Teaching Hospital, PMB 228, Abuja 900001, Nigeria
4Department Obstetrics and Gynaecology, Federal Medical Centre Nguru, Nguru 630001, Nigeria
5Federal Medical Centre Owerri, Owerri 460001, Nigeria
6Department of Paediatrics, Federal Teaching Hospital Abakaliki, Abakaliki 480001, Nigeria
7Federal Medical Centre Lokoja, Lokoja 260001, Nigeria
8University of Benin Teaching Hospital, P.O. Box 1111, Benin-City 300001, Nigeria

Received 24 March 2014; Revised 19 June 2014; Accepted 1 July 2014; Published 22 July 2014

Academic Editor: Naveed Hussain

Copyright © 2014 Hippolite O. Amadi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Millennium development goal target on infant mortality (MDG4) by 2015 would not be realised in some low-resource countries. This was in part due to unsustainable high-tech ideas that have been poorly executed. Prudent but high impact techniques could have been synthesised in these countries. A collaborative outreach was initiated to devise frugal measures that could reduce neonatal deaths in Nigeria. Prevailing issues of concern that could militate against neonatal survival within care centres were identified and remedies were proffered. These included application of (i) recycled incubator technology (RIT) as a measure of providing affordable incubator sufficiency, (ii) facility-based research groups, (iii) elective training courses for clinicians/nurses, (iv) independent local artisans on spare parts production, (v) power-banking and apnoea-monitoring schemes, and (v) 1/2 yearly failure-preventive maintenance and auditing system. Through a retrospective data analyses 4 outreach centres and one “control” were assessed. Average neonatal mortality of centres reduced from 254/1000 to 114/1000 whilst control remained at 250/1000. There was higher relative influx of incubator-dependent-neonates at outreach centres. It was found that 43% of mortality occurred within 48 hours of presentation (d48) and up to 92% of d48 were of very-low birth parameters. The RIT and associated concerns remedies have demonstrated the vital signs of efficiency that would have guaranteed MDG4 neonatal component in Nigeria.