EFFICIENT SECONDARY NEONATAL HEALTHCARE SYSTEM; THE MISSING LINK TO THE REDUCTION OF NEONATAL MORBIDITY AND MORTALITY, AN URGENT CALL TO ACTION

Abstract

Background:
Kaduna state recorded a neonatal mortality rate of 64 deaths per 1000 live births (LB) in 2018. The major causes being prematurity,
asphyxia, neonatal infections and neonatal jaundice. Successful management of these cases can only be achieved when standard quality care is offered in well- equipped and functional appropriate level of neonatal care. Sick neonates unable to access neonatal care units are at increased risk of morbidities and death.

Objective: To assess availability and functionality of public secondary-level neonatal in-patient care services in Kaduna state.
Methods: The study is a cross-sectional observational survey using mixed methods to evaluate the neonatal health care services as
part of the reforming and strengthening the neonatal health care services in Kaduna state. Results: Three (10%) of the 30 public secondary health care facilities in the state provided some degree of in- patient neonatal health care services. None of the 3 Neonatal units had distinctly separate in- and out- born wards, a kangaroo mother care (KMC) room, breastfeeding room or mothers’ room. None of the facilities had a functional intensive phototherapy device, a bubble CPAP machine, multiparameter
monitor or transport incubator. None of the facilities operated a distinct neonatal level of care nor were the staff aware of levels of neonatal care Overall, staff were inadequate and of insufficient mix.
Conclusion: There is lack of efficient secondary neonatal health care system in Kaduna state, Nigeria. This is a critical missing link to significant and successful reduction of neonatal morbidity and mortality.

We urge that steps and actions be taken to expedite the reformation and strengthening of the health system to enable establishment of standard, quality secondary neonatal healthcare systems in all public secondary health care facilities.