Scope of neonatal care services in major Nigerian hospitals

Abstract

Background: Neonatal survival bespeaks the quality of neonatal care services available and ccessible to the population. Intensive care improves outcome of high-risk infants with serious illness. The tiered level of care is yet to be applied to newborn care in Nigeria. Classification of care is key to improving neonatal survival with enhanced referral of high-risk patients to higher-level centres. Objective: To ascertain the scope and classify available newborn services offered at major Nigerian hospitals. Methodology: A semi-structured validated questionnaire was administered to attendees during 2015 Pediatric Association of Nigeria conference. The information derived was used to categorize neonatal care services. Results: The respondents consisted of doctors 201 (84.8%) and nurses 36 (15.2%) in 54 health facilities from all geopolitical regions of Nigeria. Of the 54 facilities, 34 (63%) were located in state capitals and 47 (87%) in public hospitals. Half of the evaluated units belonged to Class I, 22 (40.7%) Class II, and 5 (9.3%) Class III levels of neonatal care. Majority (81.6%) of the doctors have been trained on neonatal resuscitation; with senior residents being the highest 49 (89%) and Medical officers (MO) the least 4 (40%) trained. Doctors with training in mechanical ventilation (MV) were 39.2%; Consultants (51.2%), MO’s the least 1(11.2%) trained (p=0.025). Monitoring is usually by pulse oximeters 54 (100%), multi parameter monitors 23 (42.6%) and rarely ABGs 6 (11%). Conclusion: Neonatal care in Nigeria is still developing. Most centres provide basic neonatal care services. Regionalization of care may be the solution to higher level neonatal care.

Keywords

• neonatal care; scope