For over a period now, Ntchisi district hospital has registered a decrease in number of neonatal deaths due to sepsis thanks to Quality Improvement mentors who lobbied with Management for a separate unit for neonates both premature and sick.
Before the mentors were trained in QI by Maikhanda with support from Comic Relief, the hospital had 55% of Neonatal sepsis cases of all deliveries. Through QI training that the mentors underwent, a process mapping exercise was done so that the mentors fully understand their system and processes and realized that most neonatal sepsis cases were due to congestion in postnatal ward.
It was against this background that Maikhanda urged the hospital’s management to have one of the bays demarcated to accommodate KMC. Nevertheless, even after a demarcation using plywood was done the problem was far from over as sick babies were being put together with premature babies a situation that put the premature babies at risk of infection. In addition to that, the progress was also hindered due to shortage of staff such that no nurse was allocated to KMC and they had to rely on postnatal nurses.
Having seen that the there was no improvement and babies were still dying despite making many adaptations including moving KMC to maternity with proper demarcation of nursery and KMC, Maikhanda and the QI management partnered with Save the Children Malawi to set up a stand-alone unit for neonates with nurses and clinicians specially allocated to the unit.
Fast forward to July 2016, a new Neonatal unit was established at Ntchisi District hospital with four nurses and two clinicians specially allocated to the unit. Following this development, there was a tremendous improvement in such a way that from July 2016 to March 2017 there were only two Neonatal deaths with highest instance in November but all were managed properly. However, six months prior to the establishment of a proper neonatal unit, there were six neonatal deaths due to sepsis and adherence to sepsis protocol was very poor.