Browsing by Author "Zgambo, Austin Chibisa"

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    Survival of low birth weight babies admitted at Chiradzulu District Hospital (public) and St. Joseph Mission Hospital (private) in Malawi
    (Kamuzu University of Health Sciences, 2020-05-13) Zgambo, Austin Chibisa
    The type of research study This will be a hospital based retrospective cohort study collecting quantitative data from Nursery ward registers on Low birth weight babies. Low birth weight is defined as a birth weight of less than 2,500 g regardless of gestational age. This practical cut-off for international comparison is based on epidemiological observations that babies weighing less than 2,500 g are approximately 20 times more likely to die than those born with a weight of over 2, 500 g. Globally, it is estimated that 12 to 17% of all births are Low birth weights. However, the great majority (91%) of Low birth weight babies occur in low and middle-income countries. Malawi, being part of low-income countries, has nearly 12% of babies born with Low birth weight. Both the public and private sectors are responsible for the provision of healthcare services in the country. The problem Losing a baby is a devastating experience and every parent experiences grief in his/her own way. The World Health Assembly endorsed targets to reduce Low birth weight prevalence by 30% by 2025. Despite the availability of interventions to improve survival of Low birth weight babies, it still remains a challenge in low resource settings. People have a perception that quality of care is better in private hospitals than public hospitals partly due to differences in resource base. Consequently, better patient outcomes are expected in private than in public healthcare facilities. However, research analysis revealed that private sector health facilities had poorer patient outcomes compared to public sector health facilities. But this general analysis may not apply to all specific areas of health outcomes, for example, survival of low birth weight babies in these private and public health care facilities. Furthermore, few studies on neonatal survival have been conducted in Malawi but none of them has compared survival rates of low birth weight babies in public and private hospitals. Therefore, this study is intended to fill knowledge gap concerning survival rates of Low birth weight babies from admission to hospital discharge and the comparison of it between a public and private hospital. The Objectives The aim of the study is to compare the survival rates of Low birth weight babies admitted at Chiradzulu public hospital and St. Joseph’s private mission hospital; and to determine factors associated with mortality in these hospitals. Methodology It will be done in Chiradzulu district, specifically at Chiradzulu district hospital and St. Joseph’s Mission hospital’s nursery wards. The study will assess records of Low birth weight babies admitted in nursery wards at two hospitals between 1 January 2018 and 31 December 2019. Systematic random sampling will be used to achieve a calculated sample size. A pretested data extraction tool will be used for data abstraction. There could be a possibility of missing records but use of recent period (2018 – 2019) coupled with use of both case files and ward admission registers will ease the problem of missing data. Data will be entered in a Microsoft Excel application and later exported to STATA version 14 for analysis. Results will be presented in tables and graphs’ format. Ethical clearance will be obtained from the University of Malawi’s College of Medicine Research and Ethics Committee (COMREC). A written permission letter will be obtained from Chiradzulu District Council through the Director of Health and Social Services. Expected findings and their dissemination We are anticipating knowing the survival rates of Low birth weight babies between a public and private hospital; and common contributing factors to mortality among these babies. Knowledge of neonatal survival rates and mortality factors will help hospital managers to implement and/or scaleup appropriate interventions in nursery wards. The results will be shared with COMREC; Chiradzulu and St. Joseph’s hospitals; Malawi Ministry of Health, through the Reproductive Health Unit and published in Malawi Medical Journal for publicity at local as well as global level.