Submission ID 130475
| Issue/Objective | Neonatal hypothermia (axillary temperature <36.5°C) remains a significant yet preventable contributor to neonatal morbidity and mortality in low- and middle-income countries. In Ghana, inconsistent adherence to thermal care practices undermines essential newborn care. This study evaluated the burden and determinants of hypothermia and implemented a quality improvement (QI) intervention at a tertiary facility. |
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| Methodology/Approach | A retrospective review of 601 neonatal admissions at HopeXchange Medical Centre (November 2023-April 2025) was conducted. Demographic and clinical variables were analyzed using chi-square and logistic regression to identify predictors of hypothermia. Root cause analysis informed targeted interventions implemented through Plan-Do-Study-Act (PDSA) cycles. |
| Results | Hypothermia prevalence at admission was 28.8%, with higher rates among preterm (45.3%) and low-birth-weight infants (45.9%). Independent predictors included prematurity (AOR=2.00; 95% CI:1.32-3.32) and abnormal birth weight (AOR=1.93; 95% CI:1.23-3.06), while skin-to-skin care was protective (AOR=0.42; 95% CI:0.21-0.83). Notably, 52.1% of neonates who died were hypothermic at admission. System gaps included inadequate caregiver education, suboptimal thermal practices, and equipment failures. Interventions included staff training on WHO warm chain principles, antenatal education, and equipment restoration. |
| Discussion/Conclusion | Neonatal hypothermia remains a critical and modifiable risk factor for mortality. Context-specific QI interventions integrating staff training, caregiver engagement, and system strengthening significantly improve thermal care practices. Scaling such interventions can accelerate progress toward neonatal survival targets and global health equity goals. |
| Presenters and Affiliations | Frederick Ayensu HopeXchange Medical Centre Doris Abapiri Elijeko Foundation Gift Marcus Agyemang Elijeko Foundation Christabel Wouters Elijeko Foundation Victoria Agyeiwaa Sarfo Elijeko Foundation Nina Aziewoda Elijeko Foundation |
