Predictors and Complications of Prematurity in Two Health Facilities in Fako Division, Southwest Region, Cameroon

Background: Prematurity is the leading cause of neonatal mortality. Most preterm births can be associated to an identifiable risk factor. In Cameroon, especially in the Southwest Region, there is limited data regarding prematurity associated risk factors. The aim of this study was to evaluate the risk factors and complications of prematurity in two health facilities in the Fako division, the BRH and RHL. Methods: A hospital based retrospective case control study was done from the 1st of January 2021 to 28th of February 2022. We assessed the gestational ages at which preterm birth occurred and their short-term outcome using a structured pretested questionnaire to collect data from files. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 26. Results: The minimum sample size was 137 preterms. 45.5% of cases were born between 34 and increased the risk of having a preterm birth meanwhile being married (AOR: 0.410;95% CI: 0.217 - 0.773;p = 0.006) decreased the risk. Hospital complications were neonatal infection 103 (51.5%), respiratory distress 79 (39.5%) and neonatal jaundice 61 (30.50%). Among the cases, 97 (48.50%) stayed in the hospital for 2 to 4 weeks and 177 (88.5%) were discharged alive. Conclusions: Modifiable factors that increased the risk of prematurity were advanced maternal age, secondary level of education, rural residence, and prenatal alcohol consumption. Being married decreased the risk. The most common hospital complications in both the cases and controls were neonatal infection, respiratory distress syndrome and neonatal jaundice.

Hospital Outcome of Newborns with a Health Cheque System in Comparison to Those Without

Introduction: The health cheque system is a prepayment mechanism aimed at reducing neonatal and maternal mortality through improving the management of pregnant women. The pregnant woman with the health cheque system that she pays at six thousand francs XAF (African financial community) is covered free of charge for all the care provided by the cheque system in the health facilities accredited to the health cheque project. We did a study, with objective to determine the hospital outcome of newborns with a health cheque system (HCS) compared to those without health cheque system. Method: A descriptive cross-sectional study with retrospective data collection was carried out at the Ngaoundere Regional Hospital from January 2018 to September 2021. Results: During our study period, 2985 newborns were received. We saw an increase in admissions over the years, particularly in the group of newborns with the health cheque system. Comparatively, the percentage of newborns cured in the health cheque system group was 76.73% (n = 1643) versus 77.72% (n = 656) those in the non-health cheque system group. Those who died were 8.96% (n = 192) in the health cheque system group compared to 6.27% (n = 53) in the non-health cheque system group. Conclusions and Recommendations: Most patients admitted to our service have the health cheque system. We notice an increase in hospital attendance with the health cheque project. The outcome of the newborn under the health cheque system is not different from that without health cheque system. The health cheque system was successful in getting the larger number of newborns into care. The next step is to put strategies in place to keep these patients in care for the duration of hospitalization.