Structure Funding Hospital Umum Sarawak, Kuching, Sarawak

25 2. Data Set 2.1 Participating Centres in 2008: 1. Hospital Sultanah Bahiyah, Alor Setar, Kedah 2. Hospital Ampang, Selangor 3. Hospital Batu Pahat, Johor 4. Hospital Universiti Sains Malaysia, Kelantan 5. Hospital Raja Perempuan Bainun, Ipoh, Perak 6. Hospital Tuanku Fauziah, Kangar, Perlis 7. Hospital Kajang, Selangor 8. Hospital Keningau, Sabah 9. Hospital Raja Perempuan Zainab II, Kota Bahru, Kelantan 10. Hospital Kuala Lumpur, Kuala Lumpur Federal Territory 11. Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu 12. Hospital Likas, Kota Kinabalu, Sabah 13. Hospital Melaka, Melaka 14. Hospital Miri, Sarawak 15. Hospital Pakar Sultanah Fatimah, Muar, Johor 16. Hospital Pulau Pinang, Pulau Pinang 17. Hospital Putrajaya, Putrajaya Federal Territory 18. Hospital Seberang Jaya, Pulau Pinang 19. Hospital Selayang, Selangor 20. Hospital Serdang, Selangor 21. Hospital Tuanku Jaafar, Seremban, Negri Sembilan 22. Hospital Seri Manjung, Perak 23. Hospital Sibu, Sarawak 24. Hospital Sg. Buloh, Selangor 25. Hospital Sultan Abdul Halim, Sg. Petani, Kedah 26. Hospital Sultanah Aminah, Johor Bharu, Johor 27. Hospital Taiping, Perak 28. Hospital Tengku Ampuan Rahimah, Klang, Selangor 29. Hospital Tengku Ampuan Afzan, Kuantan, Pahang 30. Hospital Teluk Intan, Perak 31. Hospital Sultan Haji Ahmad Shah, Temerloh, Pahang 32. Hospital Umum Sarawak, Kuching, Sarawak Centre numbers allocated to centres were different from the numbers above. 2.2 Levels of Neonatal Care Care for the newborn is provided at three levels. See Appendix 1 Hospitals with a Level III NICU provide all the above levels of care and were referred to in this report as tertiary hospitals. Most Level III NICUs are in Ministry of Health hospitals and a few are in university hospitals. A total of about 40 government and three university hospital centres in the country provided neonatal intensive care to sick babies in 2008, and 32 of these NICUs are source 26 data producers SDPs of the MNNR 31 NICUs in government hospitals and one NICU attached to a university. The majority of the state hospitals or larger NICUs in Selangor offered Level IIIB care in all aspects except for the availability of HFOV and nitric oxide and subspecialties in some hospitals. These hospitals would accept the more ill and smaller babies from the smaller NICUs Level IIIA Hospitals in the study, although the latter hospitals do manage the ELBW extremely low birth weight babies in smaller numbers. There were neonatologists in 14 out of the 32 centres. Many hospitals in the country provide only Level I and II neonatal care and refer the more sick or ill babies to Level III NICUs, when the need arises. 2.3 Registration criteria The MNNR audit of critically ill babies admitted to Neonatal Units NNUs included A. All babies admitted to a Neonatal Unit who 1. had a gestation of 32 weeks i.e. up to 31 weeks + 6 days. 2. had a birth weight of 1500 g and below. 3. were ventilated. 4. had significant congenital anomalies. . B. All neonatal deaths i.e. newborn babies 28days who die in the NNU, delivery room i.e. operating theatre, labour room, and in other wards Both inborn and outborn babies will be included but outborn babies who die before arrival will be excluded. Babies who are admitted to the NNU at a corrected gestation of 4452 will not be considered a neonatal case and hence will be omitted from the study.

2.4 Data set variables The variables and their definitions are listed in Appendix 2.

The Case Report Forms CRFs include the name of hospitals for ex-utero transfer and place of death. Data on all inborn births according to birth weight and ethnicity was also collected to facilitate calculation on perinatal and neonatal mortality rates of each hospital. Appendix 3 Birth Census In this report, babies are referred to as ‘very preterm’ if they are less than 32 completed weeks’ gestation, ‘preterm’ if they are less than 37 completed weeks’ gestation, and ‘term’ if born at 37 weeks’ gestation or more. Very low birthweight VLBW babies are babies with birth weight BW 501- 1500g and extremely low birthweight ELBW babies below birth weight of 1000g. 2.5 Data Collection The CRF consisted of four sheets of forms. Appendix 4 CRF Babies discharged or transferred out to non-paediatric wards e.g. paediatric surgical wards in the same hospital or to other hospitals will have only one set of CRF completed and readmission of the same babies into the NNU will require a new set of CRF.