A study of perinatal risk in Abidjan (Ivory Coast).

The management of sick neonates is constrained in developing countries by t he limited number of neonatal units. Disorders in 507 neonates admitted to the pediatrics department of the Cocody Teaching Hospital between June 1 an d November 30, 1995, were studied. The ability of primary health care facil ities to prevent a number of disorders and to provide sick neonates with ap propriate care prior to their transfer was evaluated. The main causes of ne onatal morbidity were infection (34%), neurological failure (20%), prematur ity (17%), and respiratory distress (13%). The most common causes of death were prematurity (29.54%), neurological failure (29.12%), respiratory distr ess (27.27%), bleeding syndromes (26.92%), and infection (15.78%). These ca uses were accompanied and/or interwoven with the causes of maternal mortali ty. The working conditions in primary health care facilities compromise the health of both mothers and neonates. Simple procedures such as vitamin K1 injection, tetanus antitoxin injection, measures to improve the condition o f premature babies prior to transfer, and compliance with the rules of asep sis should be standardized. If they are to provide quality care, primary ca regivers need to be the recipients of awareness-enhancing efforts, continui ng education, and goal-oriented problem-solving training. Also vital is ori entation of activities aimed at promoting maternal and neonatal health at t he community level. Teaching hospitals should support these efforts.