Original Research

Neonatal death audits at Kgapane Hospital, Limpopo province

Gert J.O. Marincowitz, Clara Marincowitz
South African Family Practice | Vol 65, No 1 : Part 4| a5815 | DOI: https://doi.org/10.4102/safp.v65i1.5815 | © 2023 Gert J.O. Marincowitz, Clara Marincowitz | This work is licensed under CC Attribution 4.0
Submitted: 16 August 2023 | Published: 22 December 2023

About the author(s)

Gert J.O. Marincowitz, Department of Family Medicine, Faculty of Health Sciences, University of Limpopo, Mankweng, South Africa
Clara Marincowitz, Department of Psychiatry, Faculty of Health Sciences, University of Stellenbosch, Cape Town, South Africa; and SA Medical Research Council, Cape Town, South Africa


Background: Neonatal deaths (NNDs) are a global public health challenge, predominantly affecting low- and middle-income countries. The causes of most NNDs are preventable. Therefore, this study reviewed perinatal clinical audit data at Kgapane Hospital over a 4-year period with a special focus on the factors associated with NNDs.

Methods: File audits were performed for all NNDs occurring at Kgapane Hospital and its catchment area from 2018 to 2021. The data from these audits were analysed to identify factors associated with NNDs.

Results: The NND rate for the study period was 12.6/1000 live births. In this study (n = 236), 90% of the deaths could be associated with four factors, namely prematurity (44%); intrapartum complications (19%) including asphyxia, meconium aspiration and breech deliveries; neonatal infections (16%) of which human immunodeficiency virus (HIV) positivity was the most prevalent; and foetal congenital abnormalities (11%). The modifiable factors included inadequate intrapartum foetal monitoring; delays in management interventions; instances where no attempts were made to refer patients for specialised care, or where no beds were available at the next level of care; patient-related factors; and inadequate adherence to management protocols, such as for the management of prematurity and HIV.

Conclusion: Understanding factors associated with NNDs can guide health worker training and improvement strategies to reduce this heart-breaking complication of pregnancy.

Contribution: Family physicians working in rural hospitals are also responsible for newborn care. Understanding the factors associated with NNDs will guide them to focus training and develop improvement strategies to reduce these preventable deaths.


neonatal death; perinatal; audit; rural health; district hospital.

Sustainable Development Goal

Goal 3: Good health and well-being


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