| dc.description.abstract |
Neonatal hypothermia is a great concern with near epidemic levels globally. In Kenya, its
prevalence is as high as 87% with limited local data on the associated factors such as adher ence to warm chain guidelines as recommended by the World Health Organisation (WHO)
is limited. This study aimed to determine the prevalence of hypothermia and level of adher ence to the WHO thermal care guidelines among newborns admitted at Moi Teaching and
Referral Hospital (MTRH). It adopted a prospective study design of following up neonates
for the first 24 hours of admission to the MTRH newborn unit. Thermometry, interview of
mothers and observation of thermal care practices was done. Descriptive and inferential sta tistical techniques were adopted. Specifically, Pearson’s chi-square test of associations
between predictors of neonatal hypothermia and management outcomes was conducted
with their corresponding risk estimates at 95% confidence interval. Among the 372 partici pants, 64.5% (n = 240) were born at MTRH, 47.6% (177) were preterm and 53.2% (198)
had birth weights below 2500 grams. Admission hypothermia was noted among 73.7%
(274) and 13% (49) died on the first day of admission. Only 7.8% (29) newborns accessed
optimal thermal care. Prematurity, day one mortality and adherence to the warm chain were
significantly (p<0.001) associated with admission hypothermia. Inappropriate thermal appli ance, inadequate clothing and late breastfeeding significantly increased the risk of neonatal
hypothermia. Absence of admission hypothermia increased the likelihood of neonatal sur vival more than twenty-fold (AOR = 20.91, 95% CI: 2.15–153.62). Three out four neonates
enrolled had admission hypothermia which was significantly associated with prematurity,
lack of adherence to warm chain and increased risk of neonatal mortality on the first day of
life. There was low adherence to the WHO thermal care guidelines. This should be opti mized among preterm neonates to improve likelihood of survival |
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