title: Perinatal mortality in the Special Care Nursery of Moi Teaching and Referral Hospital, Eldoret, Kenya.
abstract: OBJECTIVE
  To determine the mortality rate and causes of death of all infants admitted to the Special Care Nursery (SCN) of a tertiary referral hospital in rural Kenya.
  
  
  METHODS
  Prospective and Cross-sectional study
  
  
  METHODS
  Special Care Nursery, Moi Teaching and Referral Hospital, Eldoret, Kenya.
  
  
  METHODS
  All infants admitted to the Special Care Nursing (SCN).
  
  
  METHODS
  Survival status at seven postnatal days; major causes of mortality and morbidity.
  
  
  RESULTS
  Three hundred and thirty five babies were studied between February and September 1999. Out of these 167 (49.9%) were male. There were 50 (15%) preterm and 124 (37.3%) low birth weight babies. There were 198 (76.2%) appropriate for gestational age (AGA), 46 (17.7%) small for gestational age and 16 (6.2%) large for gestational age babies. The seven day mortality rate of infants admitted to the Special Care Nursery was 66 (19.7%). Birth asphyxia and respiratory distress accounted for most deaths. Infants who were admitted primarily because the mother remained under general anesthesia generally did well. Logistic factors, including inadequate training for neonatal resuscitation in ward cadre of staff, unavailability of trained paediatricians and obstetricians, and inadequate operating theatre supplies were all found to delay treatment and likely to increase mortality.
  
  
  CONCLUSIONS
  Morbidity and mortality of infants born at the MTRH remain high. The most common cause of mortality remains birth asphyxia. Some causative factors, such as lack of resources or personnel, are logistic and could be rectified. Antenatal care had a significant positive impact on both morbidity and mortality.
authors.affiliation: Department of Child Health and Paediatrics, Faculty of Health Sciences, Moi University, PO Box 6121, Eldoret, Kenya.
authors.forename: S O
authors.initials: SO
authors.lastname: Ayaya
authors.forename: F O
authors.initials: FO
authors.lastname: Esamai
authors.forename: J
authors.initials: J
authors.lastname: Rotich
authors.forename: E
authors.initials: E
authors.lastname: Liechty
mesh_terms: D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007630:Kenya / Q000453:epidemiology; D008297:Male; D009725:Nurseries, Hospital / Q000706:statistics & numerical data*; D011446:Prospective Studies