Assessment of the neonatal referral and transport system for patients with gastroschisis in Kenya
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In brief
In brief
This Kenyan study of 29 gastroschisis patients revealed critical gaps in neonatal transport protocols, with zero compliance for incubator use, monitoring charts, and bowel assessment during referral to tertiary care. The findings highlight urgent need for standardized pre-transit and transport protocols in resource-limited settings.
Written by the GCMD Library team from the article.
Abstract
Purpose
To assess the neonatal referral and transport system for gastroschisis patients referred to a tertiary level hospital in Kenya.
Methods
This was a prospective cross-sectional study carried out at Kenyatta National Hospital (KNH) which recruited patients with gastroschisis using consecutive sampling approach. Data were collected on pre-, intra-transit factors, time and distance covered. Assessment was done using pre and intra transit factors as per the standard transport protocols in literature.
Results
Twenty-nine patients presented with gastroschisis during the eight month study period. Mean age was 7.07 h. There were 16 (55.2%) males and 13 (44.8%) females. Mean birthweight was 2020 g, and a mean gestational age of 36.5 weeks. Mean duration of transit was 5 h. Mean distance from referring facility was 153.1 km.
Most affected factors in the pre-transit protocol were lack of monitoring chart (0%), comment on blood investigations (0%), gastric decompression (3.4%), and prenatal obstetric scan (44.8%).
For intra-transit scores, most affected were incubator use (0%), bowel monitoring (0%), functioning nasogastric tube (13.8%), and adequate bowel cover (34.5%).
Conclusion
This study demonstrates that pre-transit and transit care of neonates with gastroschisis is inadequate in Kenya. Interventions needed, as identified by this study, to promote care of neonates with gastroschisis are advised.