Effectiveness of structured transport of newborns with surgical conditions on their outcomes

Abstract

Background: Many surgical conditions in newborns are only amenable to surgery, which in resource-limited settings is only feasible in  some tertiary-level hospitals, hence the need for appropriate referral and safe newborn transport.

Objective: To evaluate the  effectiveness of a structured standard operating procedure (SOP) for newborn transport, on their referral and transport characteristics.  

Design: A Cluster Randomized Controlled Trial.

Setting: Moi Teaching and Referral Hospital (MTRH).

Methods: Ten county hospitals that  refer newborns with surgical conditions to the MTRH were selected and randomized into Intervention Group (A) and Control Group (B). A  structured SOP for newborn transport was implemented in the hospitals in Group A. Thereafter, 126 newborns (63 in Group A and 63 in  Group B) that were referred from the selected county hospitals were enrolled, upon their admission to MTRH. Data was collected and  analyzed; and the outcomes of the newborns in the two groups were compared to assess the effect of the structured SOP.

Results: The  median age at admission was 4.1 days in Group A, and 4.6 days in Group B. Twenty (31.7%) mothers in Group A and 26 (41.3%) mothers in  Group B did not seek antenatal care during pregnancy. There were statistically significant differences (p < .05) in all the elements of  pre-transport stabilization, and care during transport, of the newborns referred and transported from the two groups of county hospitals. 

Conclusion: The structured SOP for newborn transport had a significant positive effect on their referral and transport  characteristics at MTRH.