Neonatal Surgery at a Regional Hospital in Northern Ghana

Background: Congenital anomalies requiring surgical intervention are a major cause of neonatal morbidity and mortality in low- and middle-income countries (LMICs). In 2023, the Upper East Regional Hospital, Ghana, received its first resident paediatric surgeon and established a neonatal surgical unit. Aim: This study reviewed the case profile, surgical procedures, and early outcomes of neonates managed at the unit. Methods: We conducted a retrospective review of medical records for all neonates admitted to the neonatal surgical unit from September 2023 to September 2025. All neonates admitted to the unit were included. Data were obtained from the hospital’s health information system, admission and discharge registers, and operative notes. Results: A total of 107 neonates were admitted, with 52.8% being males. The most common diagnoses were jejunal atresia (n=14, 13.0%), anorectal malformation (n=13, 12.0%), exomphalos (n=12, 11.1%), gastroschisis (n=10, 9.3%), and Hirschsprung disease (n=10, 9.3%). Thirty-eight neonates underwent major surgery, most frequently resection and anastomosis (39.5%) and colostomy (36.8%). Overall mortality was 20.6%. Duodenal atresia (50.0%), jejunal atresia (42.9%), and necrotising enterocolitis (40.0%) accounted for the highest case-specific mortalities. Conclusion: The establishment of a paediatric surgeon-led neonatal surgical unit has improved access to specialised care in Northern Ghana, with survival outcomes comparable to other African settings. However, mortality remains high for complex intestinal anomalies. Strengthening referral systems, neonatal intensive care capacity, and specialised workforce training will be critical to improving outcomes further. Keywords: Neonatal Surgery, Congenital Anomalies, Surgical Outcomes, Paediatric Surgery