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 Help ParticipantsAssign Managing Editor SettingsBhutan Health Journal Author SettingsDoctor Tulsi Ram Sharma Production Ready FilesSearch Upload File Name Date Component Settings 711-1 Article Text, NICU Manuscript Revised (1).docx August 4, 2020 Article Text Production Discussions Add discussion Name From Last Reply Replies Closed No Items Galleys Add galley Name SettingsPDF Public Knowledge Project Submission and Publication Metadata Close Panel Submission Identifiers Section Original Article Articles must be submitted to one of the journal's sections.* Section Policy It includes report of a case with literature review that includes, an unexpected association between diseases or symptoms, an unexpected event in the course of observing or treating a patient, findings that shed new light on the possible pathogenesis of a disease or an adverse effect, unique or rare feature of a disease, unique therapeutic approaches, approaches to a disease management, a patient whose diagnosis was difficult to make, changes in one or more patients with chronic conditions over an extended time period, report on two or more patients with similar characteristics who received different interventions and had different outcomes, atypical management of patients with common problems, a typical patient presentations, apply theory to patient or client management, report on an administrative or academic experience. Word limit for the case report should be approximately Approximately, 1500-2000 words (excluding title, unstructured abstract of 150 words and references) has been permitted for case reports. Number of references depends upon the type of case but we recommend limit it to 5-10 references. Section Policy These are literature based reviews of the current state of understanding on a topic which analyzes, or discusses management and treatment approaches to any clinical conditions in the field of clinical medicine to improve the quality of patient care or the understanding of a disease process. Articles relevant to our Bhutan’s context are particularly encouraged. Word limit for the article has to be approximately ~2500-3000 words (excluding unstructured abstract (200 words) and references of (> 50 and <100). Section Policy Letter to the editor may be regarding any clarifications or explanations about the published article in the Journal or feedback or important commentaries within the word limit of 500-1000 words. We do not require abstract but references up to 5. Section Policy These are usually solicited but unsolicited material may also be considered (approx. 1000 to 1200 words). A maximum of 10- 12 references may be included. Editorials should not have tables and figures. The editorial shall on be on topic/areas of national importance or recent updates in the field of Medicine and Health systems. Section Policy Selected summaries are of important articles published elsewhere and they provide a short summary of the paper in the reviewer’s words (not the original authors’ published abstract) followed by comments (approx. 800- 1000 words). A copy of the original publication should accompany the submission. Section Policy These are research article which doesn't fit exactly into research article but findings are interesting, e.g. pilot study. It undergoes the peer review process . A short report may include up to 1-2 tables or figures and 12 to 15 references. Prefix Examples: A, The Title* Outcomes at the Neonatal Intensive Care Unit, Eastern Regional Referral Hospital, Monggar Bhutan: A Retrospective Cohort Study Subtitle Abstract* Upload List of ContributorsOrder Add Contributor Name E-mail Role Primary Contact In Browse Lists SettingsTulsi Ram Sharma bajgai800@gmail.com Author Edit Delete SettingsPhillip Erbele dr.phillip_erbele@fnph.edu.bt Author Edit Delete SettingsHari Prasad Pokhrel hari88pokhrel@gmail.com Author SettingsPema Lethro plethro@health.gov.bt Author SettingsTshering Dhendup tdhendup@health.gov.bt Author SettingsTandin Zangpo zheynuapa@gmail.com Author Cover Image Drag and drop a file here to begin upload Submission Metadata These specifications are based on the Dublin Core metadata set, an international standard used to describe journal content. Additional Refinements Subjects* OA× Edit Contributor Close Panel Name Phillip Given Name* Erbele Family Name How do you prefer to be addressed? Salutations, middle names and suffixes can be added here if you would like. Phillip Erbele Preferred Public Name Contact dr.phillip_erbele@fnph.edu.bt Email* Country Bhutan Country* User Details Homepage URL ORCID iD
  • 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




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 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, Bhutanfrom the year 2015 to 2017.

Methods: Demographic data, neonatal and maternal variables were extracted for all Neonatal Intensive Care Unit 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




How to Cite

Sharma, T. R., Erbele, P. ., Prasad Pokhrel, H., Lethro, P. ., Dhendup, T., & Zangpo, T. (2020). Outcomes at the Neonatal Intensive Care Unit, Eastern Regional Referral Hospital, Monggar Bhutan: A Retrospective Cohort Study. Bhutan Health Journal, 6(1), 18–24. https://doi.org/10.47811/bhj.95



Original Article