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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
Using the three delays model to understand why newborn babies die in eastern Uganda
Tropical Medicine and International Health, Volume 15, No. 8, Year 2010
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Description
SummaryObjectives 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. © 2010 Blackwell Publishing Ltd.
Authors & Co-Authors
Waiswa, Peter P.
Sweden, Stockholm
Karolinska Institutet
Uganda, Kampala
Makerere University School of Public Health
Uganda, Iganga
Iganga District Administration
Källander, Karin
Sweden, Stockholm
Karolinska Institutet
Uganda, Kampala
Makerere University School of Public Health
Peterson, Stefan Swartling
Sweden, Stockholm
Karolinska Institutet
Uganda, Kampala
Makerere University School of Public Health
Sweden, Uppsala
Uppsala Universitet
Tomson, Göran B.
Sweden, Stockholm
Karolinska Institutet
Pariyo, George William
Uganda, Kampala
Makerere University School of Public Health
Statistics
Citations: 266
Authors: 5
Affiliations: 4
Identifiers
Doi:
10.1111/j.1365-3156.2010.02557.x
ISSN:
13602276
e-ISSN:
13653156
Research Areas
Health System And Policy
Maternal And Child Health
Study Design
Cross Sectional Study
Study Approach
Quantitative
Study Locations
Uganda