Outcomes at the Neonatal Intensive Care Unit, Eastern Regional Referral Hospital, Monggar Bhutan: A Retrospective Cohort Study

  • Tulsi Ram Sharma Department of Pediatric, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
  • Phillip Erbele Faculty of Nursing and Public Health, KGUMSB, Thimphu, Bhutan
  • Hari Prasad Pokhrel Gidakom Hospital, Ministry of Health, Thimphu, Bhutan
  • Pema Lethro Department of Public Health, Ministry of Health, Thimphu, Bhutan
  • Tshering Dhendup Reproductive, Maternal and Neonatal Health Program, Ministry of Health, Bhutan
  • Tandin Zangpo Department of Public Health, Ministry of Health, Thimphu, Bhutan
Keywords: Bhutan, Neonatal Intensive Care Unit, Neonatal Mortality, Outcomes


Introduction: Globally, 2.6 million neonates die every year, with more than one third of these deaths occurring within 24 hours of birth. Most neonatal deaths are preventable. The scaling up of Neonatal Intensive Care Unit (NICU) services in developing countries have shown to improve survival rates. This study aimed to determine the mortality rate, and correlate the general and clinical characteristics with the outcomes of neonates admitted in the NICU at the Eastern Regional Referral Hospital, Mongar, Bhutan from the year 2015 to 2017. Methods: Demographic data, neonatal and maternal variables were extracted for all NICU admissions from 2015 to 2017. Descriptive and analytical statistics were reported as frequencies, percentages, median, adjusted OR, 95% CI and p-values. Results: The mortality rate was 12.31%. Neonatal jaundice (49.55%), neonatal sepsis (41.74%), and
prematurity (32.43%) were the three most common diagnoses. The mortality among neonates with low birth weight (<2500 grams) was 3.68 times (adjusted OR 3.68; 95% CI: 1.39-9.77) higher than the mortality among the normal birth weight neonates and mechanically ventilated neonates were 35.85 times (adjusted OR 35.85; 95% CI: 13.12-97.87) more at risk of dying than those without mechanical ventilation. The main causes of mortality were neonatal sepsis (34.15%), prematurity (29.27%) and birth asphyxia (21.95%). Conclusion: The mortality rate at the NICU, Eastern Regional Referral Hospital is 12.31%. The study recommends to establish intermediate phototherapy/Kangaroo Mother Care/special baby care unit in the hospital to improve the
quality of new born care.


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