The role of the Neonatal Emergency Transportation Service (NETS) ambulance at dr. Ramelan Central Naval Hospital in reducing neonatal mortality rates in Surabaya
NETS reduces neonatal mortality
DOI:
https://doi.org/10.59747/smjidisurabaya.v2i2.90Keywords:
NETS, neonatal transport, referral system, neonatal mortality, survivalAbstract
Background: Limited access to health services is one of the factors that increases the risk of neonatal death. Previous studies identified inadequate transportation as a problem in the neonatal referral system in Indonesia. The Neonatal Emergency Transportation Service (NETS) was established to address this problem. NETS is equipped with an incubator, transport ventilator, and mobile vital sign monitor. Newborns transported via NETS are accompanied by a doctor and trained nurses. Objective: This study aims to compare the survival rates of newborns referred with and without using the NETS ambulance. Materials and Methods: This descriptive observational study employed a total sampling technique. Data were collected retrospectively from the electronic medical records at dr. Ramelan Central Naval Hospital, comparing the number of referrals and neonatal deaths between September 2021 and August 2022 (without the NETS ambulance) and between September 2022 and August 2023 (with the NETS ambulance). The data were analyzed using a chi-squared test (p = 0.004). Results: A total of 81 newborns were referred to the hospital using the NETS ambulance. The survival rate of newborns transported with the NETS ambulance was higher (69.1%) compared to those transported without the NETS ambulance (48.1%) (p = 0.004). The risk ratio was calculated at 0.413. Conclusion: Neonatal survival rates were higher for referrals using the ambulance compared to those without using the ambulance.
References
Abdul Wahab, M.G., Thomas, S., Murthy, P., Anbu Chakkarapani, A., 2019. Factors Affecting Stabilization Times in Neonatal Transport. Air Med. J. 38, 334–337.
Actis Danna, V., Bedwell, C., Wakasiaka, S., Lavender, T., 2020. Utility of the three-delays model and its potential for supporting a solution-based approach to accessing intrapartum care in low- and middle-income countries. A qualitative evidence synthesis. Glob. Health Action 13.
Acuin, C.S., Khor, G.L., Liabsuetrakul, T., Achadi, E.L., Htay, T.T., Firestone, R., Bhutta, Z.A., 2011. Maternal, neonatal, and child health in southeast Asia: Towards greater regional collaboration. Lancet 377, 516–525.
Balkisson, M., Kusel, B., Torborg, A.M., 2022. A retrospective review of the perioperative management of patients with congenital oesophageal atresia and tracheo-oesophageal fistula at a South African third level hospital. South. African J. Anaesth. Analg. 28, 92–98.
Brooks, M.I., Thabrany, H., Fox, M.P., Wirtz, V.J., Feeley, F.G., Sabin, L.L., 2017. Health facility and skilled birth deliveries among poor women with Jamkesmas health insurance in Indonesia: a mixed-methods study. BMC Health Serv. Res. 17, 1–12.
Cavicchiolo, M.E., Doglioni, N., Ventola, M.A., Biban, P., Baraldi, E., Trevisanuto, D., 2021. Neonatal emergency transport system during COVID-19 pandemic in the Veneto Region: proposal for standard operating procedures. Pediatr. Res. 89, 399–401.
Chirla, D., Panigrahy, N., 2021. Stabilization and Transport of Sick Neonate. In: The Handbook of Neonatology. pp. 1–10.
Deviany, P.E., Setel, P.W., Kalter, H.D., Anggondowati, T., Martini, M., Nandiaty, F., Latief, K., Weaver, E.H., Rianty, T., Achadi, A., Wahyuni, S., Setyaningtyas, S.W., Haryana, N.R., Mehrain, L.M., Achadi, E.L., 2022. Neonatal mortality in two districts in Indonesia: Findings from Neonatal Verbal and Social Autopsy (VASA). PLoS One 17, 1–15.
Gregg, A.R., Beltran-Regalado, B.A., Montero, M.L., Panda, R.M., Cucalon Calderon, J., 2024. Management of Vertebral Defects, Anal Atresia, Cardiac Defects, Tracheoesophageal Fistula or Atresia, Renal Anomalies, and Limb Abnormalities (VACTERL) in a Child With Complex Medical Needs in the Foster Care System: A Pediatric Case Study. Cureus 16.
Gudayu, T.W., 2023. Epidemiology of neonatal mortality: a spatial and multilevel analysis of the 2019 mini-Ethiopian demographic and health survey data. BMC Pediatr. 23, 1–14.
Gunn, T., Outerbridge, E.W., 1978. Effectiveness of neonatal transport. Can. Med. Assoc. J. 118, 646–649.
Hakalmaz, A.E., Topuzlu Tekant, G., 2023. Anorectal Malformations and Late-Term Problems. Turkish Arch. Pediatr. 58, 572–579.
Harahap, N.C., Handayani, P.W., Hidayanto, A.N., 2019. Barriers and technologies of maternal and neonatal referral system in developing countries: A narrative review. Informatics Med. Unlocked 15, 100184.
Hirata, K., Ueda, K., Wada, K., Ikehara, S., Tanigawa, K., Kimura, T., Ozono, K., Iso, H., Kamijima, M., Yamazaki, S., Ohya, Y., Kishi, R., Yaegashi, N., Hashimoto, K., Mori, C., Ito, S., Yamagata, Z., Inadera, H., Nakayama, T., Shima, M., Nakamura, H., Suganuma, N., Kusuhara, K., Katoh, T., 2022. Long-term outcomes of children with neonatal transfer: the Japan Environment and Children’s Study. Eur. J. Pediatr. 181, 2501–2511.
Islam, M.A., Butt, Z.A., Sathi, N.J., 2022. Prevalence of Neonatal Mortality and its Associated Factors: A Meta-analysis of Demographic and Health Survey Data from 21 Developing Countries. Dr. Sulaiman Al Habib Med. J. 4, 145–152.
Jordán Lucas, R., Boix, H., Sánchez García, L., Cernada, M., de las Cuevas, I., Couce, M.L., 2021. Recommendations on the skills profile and standards of the neonatal transport system in Spain. An. Pediatr. 94, 420.e1-420.e11.
Kiputa, M., Salim, N., Kunambi, P.P., Massawe, A., 2022. Referral challenges and outcomes of neonates received at Muhimbili National Hospital, Dar es Salaam, Tanzania. PLoS One 17, 1–14.
Marsubrin, P.M.T., Ameliana, E., Sari, R., Rohsiswatmo, R., 2018. Referral case of neonatal admission and outcome at neonatal unit in cipto mangunkusumo hospital. In: Asia Pacific Congress of Pediatrics 2018. p. 2024.
Mohamed, H.A., Shiferaw, Z., Roble, A.K., Kure, M.A., 2022. Neonatal mortality and associated factors among neonates admitted to neonatal intensive care unit at public hospitals of Somali Regional State, Eastern Ethiopia: A multicenter retrospective analysis. PLoS One 17, 1–16.
Mohan, K.R., Kumar, R., 2019. Study of indications, complications and outcomes of neonatal transport by a skilled team. Int. J. Contemp. Pediatr. 6, 2402.
Neil, R., Roy, D., Langford, S., Chabernaud, J.L., Petresen, S., Peitersen, N., Kollee, L., Niijima, S.I., Agostino, R., Macagnob, F., Derganc, M., Novak-Antolic, Z., Kornhauser, P., Primo, J., Field, D., Job, L., Deming, D.D., Hopper, A.O., Peverini, R.L., 1999. Newborn transport around the world. Semin. Neonatol. 4, 219–235.
Novitasari, A., Hutami, M.S., Pristya, T.Y.R., 2020. Pencegahan dan Pengendalian BBLR Di Indonesia: Systematic Review. Pencegah. Dan Pengendali. Bblr Di Indones. 2, 175–182.
Olivo, S., Venier, D., Zannier, M., Pittini, C., Achil, I., Danielis, M., 2023. A two-year retrospective study of the neonatal emergency transport service in Northeast Italy. J. Matern. Neonatal Med. 36.
Pathirana, J., Muñoz, F.M., Abbing-Karahagopian, V., Bhat, N., Harris, T., Kapoor, A., Keene, D.L., Mangili, A., Padula, M.A., Pande, S.L., Pool, V., Pourmalek, F., Varricchio, F., Kochhar, S., Cutland, C.L., 2016. Neonatal death: Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine 34, 6027–6037.
Perry, S.E., 2021. Fifty Years of Progress in Neonatal and Maternal Transport for Specialty Care. JOGNN - J. Obstet. Gynecol. Neonatal Nurs. 50, 774–788.
Rosales, A., Sulistyo, S., Miko, O., Hairani, L.K., Ilyana, M., Thomas, J., Hirata, E., Holloway, R., Bantung, M., Pabate, K., Wijaya, C., Cherian, D., 2017. Recognition of and care-seeking for maternal and newborn complications in Jayawijaya district, Papua province, Indonesia: a qualitative study. J. Health. Popul. Nutr. 36, 44.
Schumacher, S., Mitzlaff, B., Mohrmann, C., Fiedler, K.M., Heep, A., Beske, F., Hoffmann, F., Lange, M., 2024. Characteristics and special challenges of neonatal emergency transports. Early Hum. Dev. 192, 106012.
Tey, N.P., Lai, S.L., 2013. Correlates of and barriers to the utilization of health services for delivery in South Asia and Sub-Saharan Africa. Sci. World J. 2013.
Toledo, E.R. da S., Silva, M. da, Paulo, L.G. de, Rezende, M.A., Esteves, R.Z., 2022. Neonatal transport in the emergency mobile care service: integrative review. Res. Soc. Dev. 11, e12111436142.
UN Report, 2018. A child under 15 dies every five seconds around the world – UN report.
UNICEF, WHO, The World Bank Group, UN Population Division, 2017. Levels and Trends in Child Mortality: Report 2017, United Nations Inter-Group for Child Mortality Estimation.
Wainaina, J., Ogero, M., Mumelo, L., Wairoto, K., Mbevi, G., Tuti, T., Mwaniki, P., Irimu, G., English, M., Aluvaala, J., 2024. Hypothermia amongst neonatal admissions in Kenya: a retrospective cohort study assessing prevalence, trends, associated factors, and its relationship with all-cause neonatal mortality. Front. Pediatr. 12, 1–14.
Walikota Surabaya, 2022. Peraturan Walikota Surabaya No 14 Tahun 2022.
WHO, 2018. Levels & Trends in Child Mortality: Estimates: Report 2018, Who/Unicef/World Bank/Un.
WHO, 2022. Child mortality and causes of death, The Global Health Observatory.
Xu, X.J., Li, L.N., Wu, W.Y., 2019. Importance of stabilization of the neonatal transport network in critically ill neonates. J. Int. Med. Res. 47, 3737–3744.
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