The social-economic and family background of the child with a CNS birth defect in a developing country in the current era

Objectives: In much older literature many sociocultural factors militating against the optimal clinical / surgical care of CNS birth defects in the lowmiddle income countries (LMICs) were reported. We set out to interrogate this phenomenon in the current eraMethods: A retrospective crosssectional survey of a prospective data-base of the social-economic and family background of the children with CNS birth defects presenting for surgical care in a busy neurosurgical practice in Nigeria.Results: There were 151 children, 81 males (53.6%), with hydrocephalus and neural tube closure defects (NTDs) seen in the study period; median age at presentation was at 4 weeks of life, the NTDs presenting much earlier than hydrocephalus, p-value< 0.001; each child represented the first of the parents in about a third of cases, and at least the 3rd or higher birth order in 40.4%. The parents were young adults, but the mean age of the fathers, 35.8years, was higher than the mothers’, 30.0years, p-value<0.001; the parents had low level of education and socioeconomic statuses; more than 90% had no knowledge about any preventive measures for CNS birth defects; and, in spite of their already sizeable families each, 56% of mothers, and 62% of the fathers were still gearing up for further pregnancies.Conclusions: Coupled with the region’s well-known harsh health system, the socio-economic and family background of the child with CNS birth defects remain very challenging indeed in this typical developing country. This calls for concerted efforts to promote in the LMICs the adoption of the established measures of preventing CNS birth defects.Keywords: CNS birth defects; social-economic, family background; low-middle income countries

Evaluation of care of the Newborn in delivery facilities at Osogbo, South-Western Nigeria.

In a prospective study of 193 consecutive neonates brought to the immunization clinic for vaccination at the State Hospital, Osogbo, evaluation of the neonatal care received at the facility, where the neonates were delivered was conducted. Information concerning the place of delivery of the neonates, the specifics of the care received at birth such as measurement of birth weight, the time interval between delivery and breast feeding and enquiries as to whether or not Vitamin K was administered were obtained. The biodata of all the subjects were also obtained. One hundred and fifty five (80.3%), 12(31.6%), 9(23.7%), 5(13.2), 4(10.5%), 3(7.9%), 3(7.9%), 1(2.6%), and 1(2.6%) of the 193 babies studied were delivered in the state hospital, government maternities, traditional birth centers, homes, churches, teaching hospital, private hospital, comprehensive health center and in a taxi in cases respectively. All the 159(100.0%) neonates delivered at the State and Teaching hospitals received administration of vitamin k, while all the 34(100.0%) neonates delivered at other health facilities, did not receive vitamin k. The differences between the greater proportion of all the 159(100.0%) neonates delivered at the state and teaching hospital that had their birth weight measurement taken compared with 4(11.8%) of the 34 neonates delivered elsewhere that had their birth weights measured is statistically significant. χ2= 13.75, P= 0.00 (Yate's correction applied). Data on breastfeeding commencement was obtained on 116 of a total 159 delivered at the state and teaching hospitals. Of these 116, eighty five (73.7%) were put to breast on time as against 6(17.6%) of the 34 neonates delivered at the other facilities who were breast fed on time. χ2= 32.21, P= 0.00. Yate's correction applied. These differences are statistically significant. It is concluded that the care of the newborn at non- tertiary maternity units is unsatisfactory. Health workers and birth attendants at maternities, comprehensive health centers, private hospitals and churches, need continuous training in order to ensure optimal care of the newborn in these facilities. The health ministry should also enforce good standards of practice through periodic inspections and assessment of the concerned facilities. Keywords: Evaluation, newborn, care and delivery facilities.Nigerian Hospital Practice Vol. 2 (1) 2008: pp. 3-

A Review of Neonatal Admissions in Osogbo, Southwestern Nigeria.

A retrospective analysis of the records of all neonatal admissions into the Special Baby care unit (SCBU) of LAUTECH Teaching Hospital, Osogbo between January 2006 and December 2007 was undertaken. There were 605 admissions (371 males and 234 females) with 308 (50.9%) being admitted in 2006 and 297 (49.1%) in 2007. Admission weights ranged between 0.65kg and 5.20kg with the mean weight of 2.72 ± 0.76kg. There were 317 (52.5%) inborns and 288 (47.5%) outborns. Primary indications for admission were low birth weight in 228 (47.7%), birth asphyxia in 197 (32.5%), neonatal septicaemia -154 (25.4%), neonatal jaundice 72 (11.9%) and respiratory distress in 56 (9.2%). One hundred and ten (18.2%) of the 605 babies died. Of the 110 babies who died, 80 (72.7%) were outborn while 30 (27.3%) were inborn. The pattern of the causes of death mirrors that of admissions. The main causes of admissions and deaths are preventable. The mortality of 18.2% is unacceptably high. Sick babies who had been delivered outside the teaching hospitals stood a triple chance of dying compared with those born in the teaching hospitals. To improve and work towards achieving MDG4,a much better commitment of government to maternal and child health is needed.Keywords: Neonatal admissions, morbidity, mortality, Nigeri