Birth asphyxia among causes of neonatal deaths in public health sector

Nov 21, 2018 News

Between June 2017 and July this year, there were 12 neonatal deaths recorded by neonatal intensive care units [NICU] within the public health sector. At least this is based on information provided to the National Assembly by Senior Minister of Public Health, Ms. Volda Lawrence, in response to questions posed by parliamentary opposition member, Dr. Vindhya Persaud.
Based on Lawrence’s recent presentation to the House, in June 2017, one neonatal death was recorded at the New Amsterdam Hospital, which was a result of severe hypoxic ischaemic encephalopathy [HIE]. HIE is characterised by clinical and laboratory evidence of acute or sub-acute brain injury due to asphyxia. The primary causes of this condition are systemic hypoxemia and/or reduced cerebral blood flow. According to reports, birth asphyxia causes some 840,000 or 23 percent of all neonatal deaths worldwide.

Ms. Volda Lawrence, Senior Minister of Public Health

Another two deaths at the same institution were due to pulmonary haemorrhaging [bleeding into the lungs] and congenital malformation [structural or functional anomalies]. They were recorded in July 2017. In October of last year, two neonatal deaths recorded were as a result of pulmonary haemorrhaging and congenital malformation, and another two were the result of intraventricular haemorrhage and prematurity.
November 2017 saw four deaths being recorded; including pulmonary haemorrhage and congenital cardiomyopathy at the Berbice health facility, while in July 2018, another death due to Hyaline Membrane (immature lung) was recorded too.
At the Suddie Hospital, between the period May 2017 through April 2018, seven deaths were recorded due to complications resulting from Meconium aspiration syndrome, acute respiratory failure, hyaline membrane disease, cardio-respiratory failure, bronchopneumonia, bronchoaspiration, preterm maturity, cardiorespiratory failure, congential malfunction, severe asphyxia by nuchal cord and prematurity.
In Linden, the causes of the four neonatal deaths there were due to cardiac arrest, congential cardiomyopathy, neonatal sepsis and asphyxia.
Among the institutions that were examined to determine public health’s NICU situation were the Georgetown Public Hospital Corporation [GPHC], New Amsterdam Hospital, Linden Hospital Complex, Suddie Public Hospital, Bartica Hospital and the West Demerara Regional Hospital.
As part of her presentation, the Minister shared the number of admissions from each government-run NICU during the period June 2017 to June 2018.
According to her, during the course of 2016 a total of 325 admissions were recorded which translated to 113 at the GPHC, 119 at the New Amsterdam Hospital, 79 at the Linden Hospital and 14 at the Suddie Public Hospital. There were, however, no admissions recorded for 2016 at the Bartica and West Demerara Regional Hospitals.
In 2017, there were 379, with 189 admissions at the GPHC, 83 at the New Amsterdam Hospital, 74 at the Linden Hospital, 18 at the Suddie Public Hospital, four at the Bartica Hospital and 11 at the West Demerara Regional Hospital.
Also in June 2018, a total of 151 admissions were recorded at the institutions. This amounted to 37 at the GPHC, 49 at the New Amsterdam Hospital, 43 at the Linden Hospital, 16 at the Suddie Public Hospital and three each at the Bartica and West Demerara Hospitals.
According to the Public Health Minister’s report, of the 473 admissions at the GPHC’s NICU, 69 were referred from other institutions for the period under review. The Minister disclosed too that the referral situation often results in the NICU being overcrowded.
“The NICU is often overcrowded because the GPHC cannot refuse to admit sick babies from the regions and private hospitals,” the Minister disclosed.
Between January and June of this year, the Minister reported that there were a total of 11 incubators in the GPHC’s NICU, of which five were in use and the additional six were being kept for spare use. The Minister however noted that while as of May 11, 2015, a total of 10 incubators and six ventilators were added to the NICU, by July 1, 2018, eight ventilators and five incubators were in use.
Recognising the importance of maintenance, the hospital currently has on board four qualified staff available for the maintenance of incubators and ventilators of which two are biomedical technicians and two are biomedical engineers

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