Ayman El Mohandes, MD, MPH, FAAP¹, Reginald F. Gipson, MD, MPH², Esmat Mansour Ibrahim El Sharkably, MD, MSc PhD³, Lamiaa Mohsen, MD MSc, PhD⁴, and Ismail Mohamed Bahie El Din El Hawary, MD MSc, PhD². (1) School of Public Health and Health Services, George Washington University, 2300 Eye Street, NW, Ross Hall 125-G, Washington, DC 20037, 202 994 3686, sphaxe@gwumc.edu, (2) Healthy Mother/Healthy Child, John Snow, Inc., 21 Misr Helwan Agricultural Rd., 10th floor, Maadi, Cairo, Egypt, (3) Ministry of Health/ HM-HC Project, 21, El Saba3 Sakkayat St., Kasr El Eini, Cairo, Egypt, (4) Healthy Mother/Healthy Child, John Snow, Inc, 21 Misr Helwan Agricultural Road, 10th floor, Maadi, Cairo, Egypt

Evaluation of improvement in providing adequate health care in developing countries was faced with obstacles in monitoring change in utilization rate over time. One of these obstacles relates to accuracy in vital statistics documentation. Registration of Neonatal Deaths is commonly inaccurate. We have addressed this problem in an innovative way using available data with comparison made over time to assist us in defining improvement of utilization of Neonatal Units in an underserved area of Egypt. Utilization rates have been monitored overtime using traditional indicators such as number of admissions per year and occupancy rates. In addition the proportion of Neonatal Deaths occurring in these units divided by the over all neonatal mortality registered in the same region is compared overtime. Despite the expected inaccuracy of reporting the denominator, we did not expect this inaccuracy to change over the three year period. This ratio showed a steady increase over the three year period. The significance of an increased percentage of Neonatal Mortality occurring in the Neonatal units is especially relevant when the overall mortality rate in these units is improving overtime. These findings indicate a gradual shift of Neonatal mortality from the community to the Health care facility where mortality is expected to occur for the sickest patients.

Learning Objectives: