Outcome of neonatal care in Port Moresby, Papua New Guinea: a 19-year review.

The effectiveness of changes in practice can only be determined by comparing outcome before and after their introduction. This report presents and discusses the neonatal statistics from Port Moresby General Hospital (PMGH) over the last 19 years and attempts to determine the effects of changes in practice introduced during the last year of the study period. Neonatal mortality rates have been very constant. However, the changes in practice--having all but the sickest babies nursed with their mothers and encouraging kangaroo care--together with strict adherence to breastfeeding policies, including the use of expressed breastmilk wherever possible, and the close involvement of the local breastfeeding support group in follow-up, appeared to have beneficial effects in reducing the length of stay and increasing the rate of weight gain in the very low birthweight babies.