Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya
<p>Globally, 2.4 million newborns die in the first month of life, with neonatal mortality rates (NMR) per 1,000 livebirths being highest in sub-Saharan Africa. Improving access to inpatient newborn care is necessary for reduction of neonatal deaths in the region. We explore the relationship be...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Public Library of Science
2022
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| _version_ | 1826309687948083200 |
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| author | Ouma, PO Malla, L Wachira, BW Kiarie, H Mumo, J Snow, RW English, M Okiro, EA |
| author_facet | Ouma, PO Malla, L Wachira, BW Kiarie, H Mumo, J Snow, RW English, M Okiro, EA |
| author_sort | Ouma, PO |
| collection | OXFORD |
| description | <p>Globally, 2.4 million newborns die in the first month of life, with neonatal mortality rates (NMR) per 1,000 livebirths being highest in sub-Saharan Africa. Improving access to inpatient newborn care is necessary for reduction of neonatal deaths in the region. We explore the relationship between distance to inpatient hospital newborn care and neonatal mortality in Kenya. Data on service availability from numerous sources were used to map hospitals that care for newborns with very low birth weight (VLBW). Estimates of livebirths needing VLBW services were mapped from population census data at 100 m spatial resolution using a random forest algorithm and adjustments using a systematic review of livebirths needing these services. A cost distance algorithm that adjusted for proximity to roads, road speeds, land use and protected areas was used to define geographic access to hospitals offering VLBW services. County-level access metrics were then regressed against estimates of NMR to assess the contribution of geographic access to VLBW services on newborn deaths while controlling for wealth, maternal education and health workforce. 228 VLBW hospitals were mapped, with 29,729 births predicted as requiring VLBW services in 2019. Approximately 80.3% of these births were within 2 hours of the nearest VLBW hospital. Geographic access to these hospitals, ranged from less than 30% in Wajir and Turkana to as high as 80% in six counties. Regression analysis showed that a one percent increase in population within 2 hours of a VLBW hospital was associated with a reduction of NMR by 0.24. Despite access in the country being above the 80% threshold, 17/47 counties do not achieve this benchmark. To reduce inequities in NMR in Kenya, policies to improve care must reduce geographic barriers to access and progressively improve facilities’ capacity to provide quality care for VLBW newborns.</p> |
| first_indexed | 2024-03-07T07:39:28Z |
| format | Journal article |
| id | oxford-uuid:815cefb4-3f58-4379-a80d-22698789f43b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:39:28Z |
| publishDate | 2022 |
| publisher | Public Library of Science |
| record_format | dspace |
| spelling | oxford-uuid:815cefb4-3f58-4379-a80d-22698789f43b2023-04-04T11:34:24ZGeospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in KenyaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:815cefb4-3f58-4379-a80d-22698789f43bEnglishSymplectic ElementsPublic Library of Science2022Ouma, POMalla, LWachira, BWKiarie, HMumo, JSnow, RWEnglish, MOkiro, EA<p>Globally, 2.4 million newborns die in the first month of life, with neonatal mortality rates (NMR) per 1,000 livebirths being highest in sub-Saharan Africa. Improving access to inpatient newborn care is necessary for reduction of neonatal deaths in the region. We explore the relationship between distance to inpatient hospital newborn care and neonatal mortality in Kenya. Data on service availability from numerous sources were used to map hospitals that care for newborns with very low birth weight (VLBW). Estimates of livebirths needing VLBW services were mapped from population census data at 100 m spatial resolution using a random forest algorithm and adjustments using a systematic review of livebirths needing these services. A cost distance algorithm that adjusted for proximity to roads, road speeds, land use and protected areas was used to define geographic access to hospitals offering VLBW services. County-level access metrics were then regressed against estimates of NMR to assess the contribution of geographic access to VLBW services on newborn deaths while controlling for wealth, maternal education and health workforce. 228 VLBW hospitals were mapped, with 29,729 births predicted as requiring VLBW services in 2019. Approximately 80.3% of these births were within 2 hours of the nearest VLBW hospital. Geographic access to these hospitals, ranged from less than 30% in Wajir and Turkana to as high as 80% in six counties. Regression analysis showed that a one percent increase in population within 2 hours of a VLBW hospital was associated with a reduction of NMR by 0.24. Despite access in the country being above the 80% threshold, 17/47 counties do not achieve this benchmark. To reduce inequities in NMR in Kenya, policies to improve care must reduce geographic barriers to access and progressively improve facilities’ capacity to provide quality care for VLBW newborns.</p> |
| spellingShingle | Ouma, PO Malla, L Wachira, BW Kiarie, H Mumo, J Snow, RW English, M Okiro, EA Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya |
| title | Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya |
| title_full | Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya |
| title_fullStr | Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya |
| title_full_unstemmed | Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya |
| title_short | Geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in Kenya |
| title_sort | geospatial mapping of timely access to inpatient neonatal care and its relationship to neonatal mortality in kenya |
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