Effect of Early Essential Newborn Care on Reducing the Neonatal Morbidity and Mortality

Ghulam  Fatima; Shahida  Shaikh; Badar Munir

doi:10.54112/bcsrj.v6i6.1847

Authors

Ghulam Fatima Sheikh Zayed Women Hospital, Larkana, Pakistan
Shahida Shaikh Sheikh Zayed Women Hospital, Larkana, Pakistan
Badar Munir RMNCAN WHO Sub Office Sindh, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v6i6.1847

Keywords:

Breast Feeding, Hypothermia, Infant, Newborn, Intensive Care Units, Neonatal, Sepsis

Abstract

Neonatal morbidity and mortality remain critical public health challenges, particularly in low- and middle-income countries. Objective: To assess the impact of EENC on neonatal hypothermia, early-onset sepsis, NICU admissions, breastfeeding initiation, and mortality in a tertiary care setting. Methods: This prospective observational study was conducted at Sheikh Zayed Hospital, Rahim Yar Khan. A total of 85 neonates were enrolled in the study. The sample size was determined based on previous research suggesting a significant reduction in neonatal complications with EENC implementation. Results: The post-EENC group showed a significant reduction in hypothermia (7.1% vs. 24.7%, p=0.01) and early-onset sepsis (8.2% vs. 18.8%, p=0.04) compared to the pre-EENC group. NICU admissions decreased (10.5% vs. 22.3%, p=0.03), and timely breastfeeding initiation improved markedly (92.9% vs. 58.8%, p=0.001). Although neonatal mortality was lower in the EENC group (1.2% vs. 7.1%), this difference was not statistically significant (p=0.09). No adverse outcomes associated with EENC were reported. Conclusion: EENC is a safe and effective strategy that significantly improves early neonatal outcomes. Its implementation is associated with reduced hypothermia, infections, and NICU admissions, as well as enhanced early breastfeeding. These findings support the routine adoption of EENC protocols in clinical practice to reduce preventable neonatal morbidity and mortality.

Downloads

Download data is not yet available.

References

Tran HT, Mannava P, Murray JCS, Nguyen PTT, Tuyen LTM, Anh TH, et al. Early essential newborn care is associated with reduced adverse neonatal outcomes in a tertiary hospital in Da Nang, Viet Nam: a pre-post-intervention study. EClinicalMedicine. 2018;6:51–8. https://doi.org/10.1016/j.eclinm.2018.12.002

Chomba E, McClure EM, Wright LL, Carlo WA, Chakraborty H, Harris H. Effect of WHO newborn care training on neonatal mortality by education. Ambulatory Pediatrics. 2008;8(5):300–4. https://doi.org/10.1016/j.ambp.2008.04.006

Chomba E, Carlo WA, Goudar SS, Jehan I, Tshefu A, Garces A, et al. Effects of essential newborn care training on fresh stillbirths and early neonatal deaths by maternal education. Neonatology. 2017;111(1):61–7. https://doi.org/10.1159/000447421

Tran HT, Murray JCS, Sobel HL, Mannava P, Huynh LT, Nguyen PTT, et al. Early essential newborn care is associated with improved newborn outcomes following caesarean section births in a tertiary hospital in Da Nang, Vietnam: a pre/post-intervention study. BMJ Open Quality. 2021;10(3):e001089. https://doi.org/10.1136/bmjoq-2020-001089

Akter T, Dawson A, Sibbritt D. What impact do essential newborn care practices have on neonatal mortality in low and lower-middle income countries? Evidence from Bangladesh. J Perinatol. 2016;36(3):225–30. https://doi.org/10.1038/jp.2015.181

Carlo WA, Goudar SS, Jehan I, Chomba E, Tshefu A, Garces A, et al. Newborn-care training and perinatal mortality in developing countries. N Engl J Med. 2010;362(7):614–23. https://doi.org/10.1056/NEJMsa0806033

Patel AB, Simmons EM, Rao SR, Moore J, Nolen TL, Goldenberg RL, et al. Evaluating the effect of care around labor and delivery practices on early neonatal mortality in the Global Network’s Maternal and Newborn Health Registry. Reprod Health. 2020;17(1):1–11. https://doi.org/10.1186/s12978-020-01010-w

Manasyan A, Chomba E, McClure EM, Wright LL, Krzywanski S, Carlo WA. Cost-effectiveness of essential newborn care training in urban first-level facilities. Pediatrics. 2011;127(5):e1176–81. https://doi.org/10.1542/peds.2010-2158

Bryce E, Mullany LC, Khatry SK, Tielsch JM, LeClerq SC, Katz J. Coverage of the WHO’s four essential elements of newborn care and their association with neonatal survival in southern Nepal. BMC Pregnancy Childbirth. 2020;20(1):1–9. https://doi.org/10.1186/s12884-020-03239-6

Saugstad OD. Reducing global neonatal mortality is possible. Neonatology. 2011;99(4):250–7. https://doi.org/10.1159/000320332

Pammi M, Dempsey EM, Ryan CA, Barrington KJ. Newborn resuscitation training programmes reduce early neonatal mortality. Neonatology. 2016;110(3):210–24. https://doi.org/10.1159/000443875

Rasaily R, Saxena NC, Pandey S, Garg BS, Swain S, Iyengar SD, et al. Effect of home-based newborn care on neonatal and infant mortality: a cluster randomised trial in India. BMJ Glob Health. 2020;5(9):e002452. https://doi.org/10.1136/bmjgh-2017-000680

Saha U. Neonatal mortality and morbidity: the burden. In: Clinical Anesthesia for the Newborn and the Neonate. Singapore: Springer Nature Singapore; 2023. p. 3–10. https://link.springer.com/chapter/10.1007/978-981-19-5458-0_1

Ehret DY, Patterson JK, Bose CL. Improving neonatal care: a global perspective. Clin Perinatol. 2017;44(3):567–82. https://doi.org/10.1016/j.clp.2017.05.002

Qu W, Yue Q, Wang Y, Yang JL, Jin X, Huang X, et al. Assessing the changes in childbirth care practices and neonatal outcomes in Western China: pre-comparison and post-comparison study on early essential newborn care interventions. BMJ Open. 2020;10(12):e041829. https://doi.org/10.1136/bmjopen-2020-041829

Lassi ZS, Bhutta ZA. Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes. Cochrane Database Syst Rev. 2015;(3):CD007754. https://doi.org/10.1002/14651858.CD007754.pub3

Enweronu-Laryea C, Dickson KE, Moxon SG, Simen-Kapeu A, Nyange C, Niermeyer S, et al. Basic newborn care and neonatal resuscitation: a multi-country analysis of health system bottlenecks and potential solutions. BMC Pregnancy Childbirth. 2015;15(Suppl 2):S4. https://doi.org/10.1186/1471-2393-15-S2-S4

Perez K, Patterson J, Hinshaw J, Escobar C, Parajon D, Parajon L, et al. Essential Care for Every Baby: improving compliance with newborn care practices in rural Nicaragua. BMC Pregnancy Childbirth. 2018;18(1):1–9. https://doi.org/10.1186/s12884-018-2003-y