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
