Newborn Health Status and Update: A Three Years’ Experience at Level II Care in Bangladesh

Author(s): Md. Fakhrul Amin Badal*, Saiful Islam, Ashraful Islam, Md. Noor Uddin Talukder, Md. Mahmudul Hasan, Ahmed Ferdous, Md. Towhiduzzaman

District level healthcare serves as a nexus between community and district level facilities. To identify the main causes of neonatal morbidity and mortality was carried out at the Special Care Newborn Unit (SCANU) of the Department of Paediatrics, 250 bedded General Hospital, Tangail for a period of 3 years from January 2017 to December 2019. A total of 3745 neonates were included in this cohort. The ratio of male and female neonates was 1.5:1. Most of the babies were born outside in this hospital. Around 70% newborn were admitted within 24 hours of life. Most of the newborn were premature (62%). Among the premature baby, kangaroo mother care was provided 38%. Among all admitted patients, average 62.6% (56% to 70%) were discharged to home, average 7.3%, (6% to 10%) admitted newborn were referred to higher Centre, average eight point three percent (8.3%) left hospital against medical advice and death occurred twenty-point six percent (20.6%). There were 914 neonatal deaths during the three-year period. The neonatal mortality rate was 24.4%. Prematurity/ low birthweight and its complication (43.3%), Birth asphyxia (30%), sepsis/meningitis (19%), congenital anomalies (5%) were the major direct causes of death. Prematurity/low birthweight and its complication was the single largest category of cause of death in the neonatal period. Outcome of newborn was improving substantially, but neonatal sepsis is a great threat to sustain and improving health status. Challenges regarding infrastructure, skills, working settings all need to be addressed and upgraded to ensure effective coverage of newborn status.