Using the three delays model to understand why newborn babies die in eastern Uganda
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Waiswa, Peter
[1
,2
,3
]
Kallander, Karin
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Karolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Makerere Univ, Sch Publ Hlth, Kampala, UgandaKarolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Kallander, Karin
[1
,2
]
Peterson, Stefan
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Karolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Makerere Univ, Sch Publ Hlth, Kampala, Uganda
Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, SwedenKarolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Peterson, Stefan
[1
,2
,4
]
Tomson, Goran
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Karolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Karolinska Inst, Med Management Ctr, Stockholm, SwedenKarolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Tomson, Goran
[1
,5
]
Pariyo, George W.
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Makerere Univ, Sch Publ Hlth, Kampala, UgandaKarolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
Pariyo, George W.
[2
]
机构:
[1] Karolinska Inst, Dept Publ Hlth Sci, Div Global Hlth, Stockholm, Sweden
[2] Makerere Univ, Sch Publ Hlth, Kampala, Uganda
[3] Iganga Dist Hlth Dept, Iganga, Uganda
[4] Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden
[5] Karolinska Inst, Med Management Ctr, Stockholm, Sweden
OBJECTIVES To investigate causes of and contributors to newborn deaths in eastern Uganda using a three delays audit approach. METHODS Data collected on 64 neonatal deaths from a demographic surveillance site were coded for causes of deaths using a hierarchical model and analysed using a modified three delays model to determine contributing delays. A survey was conducted in 16 health facilities to determine capacity for newborn care. RESULTS Of the newborn babies, 33% died in a hospital/health centre, 13% in a private clinic and 54% died away from a health facility. 47% of the deaths occurred on the day of birth and 78% in the first week. Major contributing delays to newborn death were caretaker delay in problem recognition or in deciding to seek care (50%, 32/64); delay to receive quality care at a health facility (30%; 19/64); and transport delay (20%; 13/64). The median time to seeking care outside the home was 3 days from onset of illness (IQR 1-6). The leading causes of death were sepsis or pneumonia (31%), birth asphyxia (30%) and preterm birth (25%). Health facilities did not have capacity for newborn care, and health workers had correct knowledge on only 31% of the survey questions related to newborn care. CONCLUSIONS Household and health facility-related delays were the major contributors to newborn deaths, and efforts to improve newborn survival need to address both concurrently. Understanding why newborn babies die can be improved by using the three delays model, originally developed for understanding maternal death.
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页码:964 / 972
页数:9
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[1]
[Anonymous], 2007, Uganda demographic and Health Survey 2006
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Baqui, Abdullah H.
;
Arifeen, Shams E.
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Arifeen, Shams E.
;
Williams, Emma K.
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Williams, Emma K.
;
Ahmed, Saifuddin
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Populat & Family Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Ahmed, Saifuddin
;
Mannan, Ishtiaq
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Mannan, Ishtiaq
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Rahman, Syed M.
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Rahman, Syed M.
;
Begum, Nazma
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Begum, Nazma
;
Seraji, Habibur R.
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Dept Publ Hlth, S Australia Community Hlth Res Unit, Adelaide, SA, AustraliaJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Seraji, Habibur R.
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Winch, Peter J.
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Winch, Peter J.
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Santosham, Mathuram
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Santosham, Mathuram
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Black, Robert E.
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Black, Robert E.
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Darmstadt, Gary L.
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
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Univ London London Sch Hyg & Trop Med, London WC1E 7HT, England
Touro Univ, Coll Hlth Sci, Vallejo, CA USAUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Bazzano, Alessandra N.
;
Kirkwood, Betty R.
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Univ London London Sch Hyg & Trop Med, London WC1E 7HT, EnglandUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Kirkwood, Betty R.
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Tawiah-Agyemang, Charlotte
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Kintampo Hlth Res Ctr, Ghana Hlth Serv, Kintampo, GhanaUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Tawiah-Agyemang, Charlotte
;
Owusu-Agyei, Seth
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Kintampo Hlth Res Ctr, Ghana Hlth Serv, Kintampo, GhanaUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Owusu-Agyei, Seth
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Adongo, Philip Baba
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Navrongo Hlth Res Ctr, Ghana Hlth Serv, Navrongo, GhanaUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Baqui, Abdullah H.
;
Arifeen, Shams E.
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Arifeen, Shams E.
;
Williams, Emma K.
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Williams, Emma K.
;
Ahmed, Saifuddin
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Populat & Family Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Ahmed, Saifuddin
;
Mannan, Ishtiaq
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Mannan, Ishtiaq
;
Rahman, Syed M.
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Rahman, Syed M.
;
Begum, Nazma
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Int Ctr Diarrhoeal Dis Res, Dhaka 1000, BangladeshJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Begum, Nazma
;
Seraji, Habibur R.
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Dept Publ Hlth, S Australia Community Hlth Res Unit, Adelaide, SA, AustraliaJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Seraji, Habibur R.
;
Winch, Peter J.
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Winch, Peter J.
;
Santosham, Mathuram
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Santosham, Mathuram
;
Black, Robert E.
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机构:Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
Black, Robert E.
;
Darmstadt, Gary L.
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Johns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USAJohns Hopkins Bloomberg Sch Publ Hlth, Dept Int Hlth, Int Ctr Adv Neonatal Hlth, Baltimore, MD 21210 USA
机构:
Univ London London Sch Hyg & Trop Med, London WC1E 7HT, England
Touro Univ, Coll Hlth Sci, Vallejo, CA USAUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Bazzano, Alessandra N.
;
Kirkwood, Betty R.
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Univ London London Sch Hyg & Trop Med, London WC1E 7HT, EnglandUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Kirkwood, Betty R.
;
Tawiah-Agyemang, Charlotte
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Kintampo Hlth Res Ctr, Ghana Hlth Serv, Kintampo, GhanaUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Tawiah-Agyemang, Charlotte
;
Owusu-Agyei, Seth
论文数: 0引用数: 0
h-index: 0
机构:
Kintampo Hlth Res Ctr, Ghana Hlth Serv, Kintampo, GhanaUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England
Owusu-Agyei, Seth
;
Adongo, Philip Baba
论文数: 0引用数: 0
h-index: 0
机构:
Navrongo Hlth Res Ctr, Ghana Hlth Serv, Navrongo, GhanaUniv London London Sch Hyg & Trop Med, London WC1E 7HT, England