Factors Responsible for Delay in Transport to Neonatal Intensive Care Unit (NICU) of a Tertiary Care Hospital in Karachi, Pakistan

Saleema Khowaja*, Sajid Ali**, Sarmad Muhammad Soomar***
*-*** Aga Khan University Hospital, Karachi, Pakistan.
Periodicity:February - April'2020
DOI : https://doi.org/10.26634/jnur.10.1.16958

Abstract

The purpose of this research work was to quantify referrals and transport delays to the NICU of a private tertiary care hospital and to examine the factors responsible for the delay. A qualitative descriptive pattern, with a purposive sampling was used for the study. Out of 33 referrals made at a NICU of a tertiary care hospital in Karachi, Pakistan, 27 parents were interviewed. Semi-structured interviews were carried out using open ended questions along with a demographic questionnaire. The findings of the work revealed that factors causing delay in transport of sick neonate to NICU included delay in decision making, absence of male family member, financial expenditure, and unavailability of beds at tertiary care hospitals. A large number of referrals were made to tertiary care NICU however, only few got admitted. There is a need to introduce a structured sheet to track all these referrals and take measures to speed up the transport process, and strengthen health programs and policies of the country. The activity was a huge quality improvement initiative taken by the team.

Keywords

Transportation Delay, Neonate, Factors, Neonatal Intensive Care Unit (NICU), Pakistan.

How to Cite this Article?

Khowaja, S., Ali, S., and Soomar, S. M. (2020). Factors Responsible for Delay in Transport to Neonatal Intensive Care Unit (NICU) of a Tertiary Care Hospital in Karachi, Pakistan. i-manager's Journal on Nursing, 10(1), 5-10. https://doi.org/10.26634/jnur.10.1.16958

References

[1]. Anwar, Z., & Butt, T. K. (2009). Cost of patient care in neonatal unit. Pakistan Paediatric, 33(1), 14-18.
[2]. Chowdhury, H. R., Thompson, S. C., Ali, M., Alam, N., Yunus, M., & Streatfield, P. K. (2011). Care seeking for fatal illness episodes in neonates: a population-based study in rural Bangladesh. BMC Pediatrics, 11(1), 88. https://doi.org/10.1186/1471-2431-11-88
[3]. Chowdhury, S. K., Billah, S. M., El Arifeen, S., & Hoque, D. M. E. (2018). Care-seeking practices for sick neonates: findings from cross-sectional survey in 14 rural sub-districts of Bangladesh. PloS One, 13 (9), e0204902.https://doi.org/10.1371/journal.pone.0204902
[4]. Creswell, J. W. (2013). Qualitative Inquiry & Research rd Design: Choosing among Five Approaches (3 Ed.). Thousand Oaks, CA: SAGE Publications.
[5]. Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1-4. https://doi.org/10.11648/j.ajtas. 20160501.11
[6]. Greenspan, J. A., Chebet, J. J., Mpembeni, R., Mosha, I., Mpunga, M., Winch, P. J., Killewo, J., Baqui, A. H., & McMahon, S. A. (2019). Men's roles in care seeking for maternal and newborn health: a qualitative study applying the three delays model to male involvement in Morogoro Region, Tanzania. BMC Pregnancy and Childbirth, 19(1), 293. https://doi.org/10.1186/s12884-019-2439-8
[7]. Hug, L., Alexander, M., You, D., Alkema, L., & for Child, U. I. A. G. (2019). National, regional, and global levels and trends in neonatal mortality between 1990 and 2017, with scenario-based projections to 2030: A systematic analysis. The Lancet Global Health, 7(6), e710-e720. https://doi.org/10.1016/S2214-109X(19)30163-9
[8]. Ismail, S. A., McCullough, A., Guo, S., Sharkey, A., Harma, S., & Rutter, P. (2019). Gender-related differences in care-seeking behaviour for newborns: A systematic review of the evidence in South Asia. BMJ Global Health, 4(3), e001309. https://doi.org/10.1136/bmjgh-2018-001309
[9]. Kumar, P. P., Kumar, C. D., & Venkatlakshmi, A. (2008). Long distance neonatal transport-the need of the hour. Indian Pediatrics, 45(11), 920-922.
[10]. McArthur, J. W., Rasmussen, K., & Yamey, G. (2018). How many lives are at stake? Assessing 2030 sustainable development goal trajectories for maternal and child health. Bmj Publishing Group Ltd, 360, k373. https://doi.org/ 10.1136/bmj.k373
[11]. Murthy, S., Leligdowicz, A., & Adhikari, N. K. (2015). Intensive care unit capacity in low-income countries: A systematic review. PloS One, 10(1), e0116949. https://doi.org/10.1371/journal.pone.0116949
[12]. Narang, M., Kaushik, J. S., Sharma, A. K., & Faridi, M. M. A. (2013). Predictors of mortality among the neonates transported to referral centre in Delhi, India. Indian Journal of Public Health, 57(2), 100-104.
[13]. Onarheim, K. H., Sisay, M. M., Gizaw, M., Moland, K. M., & Miljeteig, I. (2017). What if the baby doesn't survive? Health-care decision making for ill newborns in Ethiopia. Social Science & Medicine, 195, 123-130. https://10.4103/ 0019-557X.115003
[14]. Rathod, D., Adhisivam, B., & Bhat, B. V. (2015). Transport of sick neonates to a tertiary care hospital, South India: condition at arrival and outcome. Tropical Doctor, 45(2), 96-99. https://doi.org/10.1177/0049475514564270
[15]. Samuelsen, H., Tersbøl, B. P., & Mbuyita, S. S. (2013). Do health systems delay the treatment of poor children? A qualitative study of child deaths in rural Tanzania. BMC Health Services Research, 13(1), 67. https://doi.org/10. 1186/1472-6963-13-67
[16]. Shamba, D., Tancred, T., Hanson, C., Wachira, J., & Manzi, F. (2019). Delayed illness recognition and multiple referrals: a qualitative study exploring care-seeking trajectories contributing to maternal and newborn illnesses and death in southern Tanzania. BMC Health Services Research, 19(1), 225. https://doi.org/10.1186/s12913-019- 4019-z
[17]. Sharma, D. (2017). Golden hour of neonatal life: Need of the hour. Maternal Health, Neonatology and Perinatology, 3(1), 16. https://doi.org/10.1186/s40748-017- 0057-x
[18]. Upadhyay, R. P., Rai, S. K., & Krishnan, A. (2012). Using three delays model to understand the social factors responsible for neonatal deaths in rural Haryana, India. Journal of Tropical Pediatrics, 59(2), 100-105. https://doi.org/10.1093/tropej/fms060
[19]. WHO. (2015). Recommendations on Health Promotion Interventions for Maternal and Newborn Health. Geneva: World Health Organization. Retrieved from: https://www.who.int/maternal_child_adolescent/docume nts/health-promotion-interventions/en
If you have access to this article please login to view the article or kindly login to purchase the article

Purchase Instant Access

Single Article

North Americas,UK,
Middle East,Europe
India Rest of world
USD EUR INR USD-ROW
Pdf 35 35 200 20
Online 35 35 200 15
Pdf & Online 35 35 400 25

Options for accessing this content:
  • If you would like institutional access to this content, please recommend the title to your librarian.
    Library Recommendation Form
  • If you already have i-manager's user account: Login above and proceed to purchase the article.
  • New Users: Please register, then proceed to purchase the article.