ASSESSMENT OF MANAGEMENT OF NEWBORN BABIES WITH NEONATAL ASPHYXIA AT MATERNITY UNITS OF A STATE HOSPITAL IN WINDHOEK

ABSTRACT

Despite guidelines on essential and obstetric emergency care devised by the Ministry of Health and Social Services to address obstetric and neonatal related challenges in Namibia, the report on perinatal and neonatal death review of April 2010 - March 2012, indicated that birth asphyxia is in first position contributing 49.4 % to neonatal deaths. This reflects the severity of asphyxia as a public health concern in Namibia (MoHSS, 2014).

The aim of the study was to assess the management of newborn babies with neonatal asphyxia at maternity units of a hospital in Windhoek. A quantitative, descriptive and retrospective study was used on a total population of 90 patients’ files who died due to asphyxia. The sample and the population were the same (90 numbers of patients’ files). Data were collected by means of a structured checklist, analyzed with Epi info 7, as software computer package for statistical analysis purpose and presented as descriptive statistics. The results of the study showed that there was a delay with early recognition and timely decision-making on the safer method of delivery especially for cases of breech presentations, cephalopelvic disproportion (CPD) and prolonged first stage of labour. Referral of patients from district and regional hospitals to a national referral hospital takes too long. The results of the study further showed that many deliveries were conducted by registered midwives in the absence of a pediatrician or medical doctor.

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Recommendations were made with regard to improvement of knowledge and skills on maternal and neonatal care by health care providers in order to provide quality antenatal care to pregnant women, conduction of safe deliveries and provision of efficient care to the new-born babies who are at risk of asphyxia. Deliveries of cases at risk to be conducted with the presence of a paediatrician for expert resuscitation. Regulations of the referral system on maternal care should strictly be put in place regarding the hours mothers have to stay in labour after complications have been detected to prevent avoidable neonatal deaths especially due to asphyxia.