The birthweight and mortality in hospital was recorded of 567 low birth weight (LBW, < or = 2000 g) infants born/admitted during a 7 years period in Agogo Hospital situated in the rainforest area of Ghana. One hundred and fifty-two (26.8%) of these children died in hospital; 87 (57%) of them in the first 48 hours. The average length of stay in hospital of the surviving children was 11.6 days. The death rate varied from 8.4% in the 1,751 to 2,000 g group to 83.3% in infants with a birth weight < or = 1000 g. The proportion LBW children to the total newborn population was 5.5%; the proportion of extreme LBW (< or = 1000 g) to the total number LBW infants was 7.3%. The results are compared with figures from other countries, many of them with a more westernized infrastructure. In our setting, no sophisticated equipment and expensive intensive care provisions were available. This descriptive study was carried out to establish the survival rate in the neonatal period during the primary stay in hospital with low-cost conservative care. Dedicated staff members, who underwent only a simple training programme, and mothers participating in the care for their children contributed to the relatively favourable outcome.
PIP: A descriptive study of neonates admitted to the neonatal unit of Agogo Hospital in Ashanti region aimed to determine their survival rate. The unit provided low-cost conservative care for low birth weight (LBW) newborns. Mothercraft nurses comprised most of the unit's staff. They had had 10 years of elementary schooling and had worked in the hospital as a ward attendant for several years before undergoing mothercraft nursing training for one year at an orphanage. 24 hours a day, mothers participated in the care of their newborns and slept nearby. They either breast fed the newborns on demand or expressed breast milk. The expressed breast milk was provided by cup, spoon, or nasogastric tube. The neonatal unit admitted 567 newborns weighing no more than 2000 g during 1982-1989. 26.8% of these LBW newborns died in the hospital. Most neonatal deaths (57%) took place in the first 2 days. Among the survivors, the average length of hospital stay was 11.6 days (range, 10.6-14.1). Among LBW infants weighing 1500-2000 g, boys were more likely to die than girls (12.4% vs. 5.8%; p 0.05). The survival rate for newborns weighing 1500-2000 g was 90%. For those weighing 1500 g or less, it was 51.6%. The survival rate of LBW newborns weighing no more than 1250 g improved consistently over the years (p = 0.00063). These survival rates are similar to those for the UK, Canada, and The Netherlands in the 1960s and 1970s. Factors contributing to the favorable survival rates were mother participation in the newborn's care; mothercraft nurses; short distance between labor ward and neonatal unit; simple, locally made wooden incubators; and LBW newborns of greater gestational age than those in Western countries. These findings show that LBW infants (particularly those weighing more than 1500 g) born in developing countries have a reasonable likelihood of survival, if simple conservative care is provided. This care does not burden the financial resources of the community.