Survival of low birth weight babies admitted at district and private hospitals in Chiradzulu, Malawi: A retrospective cohort study
In Malawi, there are limited studies that have studied the survival of low birth weight (LBW) babies in public hospitals and no studies have studied or compared with the survival of LBW babies in private hospitals. Understanding LBW survival and factors associated with mortality would facilitate...
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| Format: | Thesis |
| Language: | English |
| Published: |
Kamuzu University of Health Sciences
2022
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| Online Access: | http://nkhokwe.kuhes.ac.mw/handle/20.500.12845/637 |
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Add Tag | Summary: | In Malawi, there are limited studies that have studied the survival of low birth weight
(LBW) babies in public hospitals and no studies have studied or compared with the
survival of LBW babies in private hospitals. Understanding LBW survival and factors
associated with mortality would facilitate the identification of better strategies to
improve their management at health facility level. The objective of the study was to
compare the survival rate of LBW babies admitted to public versus private hospital in
Chiradzulu district, Malawi; and identify maternal and newborn factors associated with
mortality in the two hospitals. A retrospective cohort study of LBW babies admitted to
Chiradzulu District Hospital (CZDH) and St. Joseph’s Private Mission Hospital
(SJPMH) from 2018 to 2019. Data were collected using a data extraction checklist from
the nursery ward admission registers. Kaplan Meier curves were used to estimate the
survival rate. A Cox proportional hazard model was fitted to identify factors associated
with mortality in LBW babies. Records for 1,343 LBW babies (698 from CZDH and
645 from SJPMH) were available for analysis. The overall survival was 87% and it was
higher at SJPMH compared to CZDH (96% versus 79%; p<.001). Delivery through
vacuum extraction (VE) (adjusted hazard ratio (AHR): 11.18; 95% CI: 1.37–95.98),
diagnoses of respiratory distress syndrome (RDS) (AHR: 2.12; 95% CI: 1.05–4.27) and
asphyxia (AHR: 2.40; 95% CI: 1.44–4.01) increased the risk of mortality. Admission
weight of the baby ranging from 1,500 to 2,499 g (AHR: 0.18; 95% CI: 0.08–0.38), and
Apgar score 7 – 10 at 5 minutes (AHR: 0.48; 95% CI: 0.27–0.86) were the protective
factors against mortality. Interventions to improve survival among the LBW babies
should focus on managing deliveries through VE, babies diagnosed with RDS and
asphyxia. |
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