Cross-sectional study of the quality of neonatal care services in Armenia

2019 ◽  
Vol 32 (8) ◽  
pp. 1145-1161
Author(s):  
Suren H. Galstyan ◽  
Hrant Z. Kalenteryan ◽  
Arshak S. Djerdjerian ◽  
Hovhannes S. Ghazaryan ◽  
Naira T. Gharakhanyan ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Quality Assessment ◽  
Neonatal Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Content Type ◽  
Neonatal Deaths ◽  
Live Births ◽  
Care Services

Purpose The purpose of this paper is to report the assessment results of the quality of neonatal care services in Armenia and to describe the identified obstacles to improving the quality of care for newborn infants. Design/methodology/approach The study carried out a cross-sectional descriptive design. The data were collected in health facilities with different levels of neonatal care that were selected employing a multi-stage, stratified purposeful sampling design. The quality of neonatal services was assessed using the generic WHO tool. Data collection was performed using face-to-face semi-structured interviews, hospital statistics, medical records and direct observations. Findings In 31 study hospitals, 31,976 deliveries were performed resulting in 31,701 live births and 734 stillbirths. About 85 percent of all neonatal deaths was attributable to early neonatal deaths with over 48 percent occurring during the first 24 h of life. The proportion of neonatal deaths was highest in infants with low birth weight constituting 92.8 percent of all neonatal deaths. The total neonatal mortality rate was 3.50 per 1,000 live births, whereas stillbirth rate and perinatal mortality rate were 22.60 and 25.26 per 1,000 total births in 2015. Specific indicators with relatively lower mean scores included neonatal resuscitation, early breastfeeding, monitoring of newborn conditions, neonatal sepsis, feeding standards, total parenteral nutrition, and infection treatment. Originality/value Given the limited scope of research on quality assessment, this paper provides valuable information on the status of quality of neonatal care services in Armenian health facilities. This work also extends the existing studies focused on quality assessment through applying the model of Avedis Donabedian with the structure–process–outcomes approach as a theoretical basis.

Quality of Antenatal, Labour and Delivery Services in Selected Districts in Malawi, Zambia and Zimbabwe: A Descriptive Cross-Sectional Study

2021 ◽  
pp. 1-9
Author(s):  
Clara Opha Haruzivishe
Keyword(s):  
Perinatal Care ◽  
Neonatal Morbidity ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Morbidity And Mortality ◽  
World Health ◽  
Performance Standard ◽  
Cross Sectional ◽  
Care Services

Background: High Maternal and Neonatal Mortality Ratios persist in Sub-Saharan Africa despite increasing perinatal care coverage. This suggests that coverage alone is not adequate to reduce maternal and neonatal morbidity and mortality. Quality of care should be the emphasis of maternal and child care services. Materials and Methods: A descriptive cross-sectional multicentre study was conducted in selected health facilities in Zambia, Malawi and Zimbabwe using purposive sampling. A World Health Organization-WHO 2016 Quality of Maternal and New-born assessment Framework and the WHO (2015) Service Availability and Readiness Assessment tool were used for data collection. Data was analyzed using Statistical Package for Social Scientist (SPSS) version 24.0. Results: Less than 43% of the health facilities satisfied at least three of the five Performance Standards of availability and adequacy of Antenatal infrastructure and supplies. Regarding Antenatal processes/care, an observation was the most common performance standard satisfied by 70.6% of all health facilities assessed while less than 30% fulfilled all other standards. Only 57.1% of the health facilities satisfied 5 of the 11 standards for labour and delivery infrastructure, while only 55.6% of the Health facilities satisfied only two of the 13 standards of Labour and delivery care. Conclusion: To achieve a significant and sustainable reduction in maternal and neonatal morbidity and mortality, there is a need for investment and improvement in maternity care services infrastructure and processes as opposed to focusing on mere attendance of Antenatal, and deliveries by trained birth attendants.

scholarly journals Determinants related to the risk of using ED among paediatric patients receiving home care services

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Scattaglia ◽  
S Campagna ◽  
G Politano ◽  
M Dalmasso ◽  
V Dimonte ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Home Care ◽  
Emergency Departments ◽  
Musculoskeletal Diseases ◽  
Home Care Services ◽  
Cross Sectional ◽  
Care Services ◽  
Paediatric Patients ◽  
Ed Visits

Abstract Introduction Pediatric home care services (PHC) are recommended to avoid hospital visits or readmission in children with chronic or complex conditions and to reduce the use of emergency departments. It would be useful to know the association of sociodemographic, clinical and health supply factors with Emergency Department (ED) access by patients receiving PHC. Methods A cross sectional retrospective cohort study was held from 2012 to 2017 in Pediatric home care services in Italy. Participants are children aged 0-18 years receiving pediatric home care services. Collected data are: sociodemographic variables (sex, age, presence or absence of an unfamiliar caregiver); distance from the ED in minutes; clinical variables (mortality rate at home, mortality rate in the ED, pathology responsible for the PHC activation and pathology determining the ED access); health supply variables (PHC proposed duration as stated by the proponent, subjects directing the patient to the ED, place of discharge after ED access, and arrival time to the ED). Results A total of 1236 PHC events contributed to 769 ED accesses. Receiving PHC services after hospital discharge (RR:1.26) and longer duration of charge-taking significantly increased the risk of experiencing ED access. The RR significantly decreased among children >5 years-of-age (RR:0.84; RR:0.62; RR;0.57; in 5-9; 10-14; 15-18 years respectively) and among children with neoplastic (RR:0.7), respiratory (RR:0.69), trauma (RR:0.4) or musculoskeletal diseases (RR:0.31) at first evaluation. Conclusions Confirming that ED accesses are issue present among children receiving home care services, this study has the main strength of demonstrating which risk factors are associated with ED accesses by children using home care services. Knowledge of them is necessary in order to implement adequate prevention strategies on both management and quality of care. Key messages Determinants associated with the risk of using emergency departments among paediatric patients receiving integrated paediatric home care services. ED visit is shown to be an issue among children receiving PHC and some determinants emerged as associated with ED visits by children in PHC.

scholarly journals The current pattern of facility-based perinatal and neonatal mortality in Sagamu, Nigeria

1970 ◽  
Vol 19 (4) ◽  
pp. 3045-3054
Author(s):  
Tinuade A Ogunlesi ◽  
Victor A Ayeni ◽  
Olusoga B Ogunfowora ◽  
Edward O Jagun
Keyword(s):  
Mortality Rate ◽  
Neonatal Mortality ◽  
Perinatal Mortality ◽  
Neonatal Death ◽  
Stillbirth Rate ◽  
Current Pattern ◽  
Neonatal Deaths ◽  
Live Births ◽  
Obstructed Labour

Background: Perinatal and neonatal mortality rates have been described as sensitive indices of the quality of health care services. Regular audits of perinatal and neonatal mortalities are desirable to evaluate the various global interventions.Objective: To describe the current pattern of perinatal and neonatal mortality in a Nigerian tertiary health facility.Methods: Using a prospective audit method, the socio-demographic parameters of all perinatal and neonatal deaths recorded in a Nigerian tertiary facility between February 2017 and January 2018 were studied.Results: There were 1,019 deliveries with stillbirth rate of 27.5/1000 total births and early neonatal death (END) rate among in-born babies of 27.2/1000 live births. The overall perinatal mortality rate for in-facility deliveries was 53.9/1000 total births and neonatal mortality (till the end of 28 days) rate of 27.2/1000 live births. Severe perinatal asphyxia and prematurity were the leading causes of neonatal deaths while obstructed labour and intra-partum eclampsia were the two leading maternal conditions related to stillbirths (25.0% and 21.4% respectively).Gestational age < 32 weeks, age < 24 hours and inborn status were significantly associated with END (p = 0.002, p <0.001 and p = 0.002 respectively).Conclusion: The in-facility perinatal mortality rate was high though stillbirth rate was relatively low. There is a need to improve the quality of emergency obstetric and neonatal services prior to referral to tertiary facilities.Keywords: Asphyxia, neonatal death, obstructed labour, perinatal death, stillbirth.

scholarly journals Effects of COVID-19 on Maternity Services in Selected Public Health Facilities from the Priority MNCH Counties in Kenya

2021 ◽  
pp. 6-10
Author(s):  
Matiang’i M ◽  
Okoro D ◽  
Ngunju P ◽  
Oyieke J ◽  
Munyalo B ◽  
...  
Keyword(s):  
Public Health ◽  
Open Data ◽  
Health Facilities ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Maternity Services ◽  
Neonatal Deaths ◽  
Public Health Facilities ◽  
Care Services

Background: Covid-19 is a rapidly evolving pandemic, affecting both developed and developing countries. Maternity services in low resource countries are adapting to provide antenatal and postnatal care midst a rapidly shifting health system environment due to the pandemic. Objectives: The objective of the study was to determine the effect of COVID-19 on maternity services in selected levels III and IV public health facilities within five MNCH priority counties in Kenya. Method: A two-stage sampling approach was used to select health facilities. The study employed cross-sectional and observational retrospective approaches. Data was collected from Maternity facilities managers and registers in a total of 28 levels III and IV facilities. Open Data Kit (ODK) formatted tools were used to collect data. Data was analysed using STATA Version 15. Descriptive statistics, Chi-square and fishers exact tests were used to analyse data. For all tests, a p-value <0.05 was taken as statistically significant. Results: A total of 31 midwifery managers were interviewed and a total of 801 maternity records (400 before COVID and 401 during COVID-19 pandemic) were reviewed from levels III (66%) and IV (34%) facilities. The managers indicated that Antenatal Care (ANC) visits had reduced (67.9%), referrals of mothers with complications got delayed (29%), mothers feared delivering in hospitals (64.5%). The managers reported that New-born care services were most affected by the pandemic (54.8%) followed by ANC services (45.2%). Facility records revealed a 19% higher ANC attendance before COVID than during the pandemic. Neonatal deaths increased significantly during Covid-19 period ((P=0.010) by 38%. Live births significantly increased during the pandemic (p <0.0001). Significant increases also observed in mothers who developed labour complications (p=0.0003) and number of mothers that underwent caesarean sections (p <0.001) during the pandemic period. Conclusion: The fear of the Covid-19 pandemic had a cross-cutting effect on utilisation of maternity services.

scholarly journals Quality of antenatal care services in selected health facilities of Kaski district, Nepal

2018 ◽  
Vol 5 (6) ◽  
pp. 2182 ◽  
Author(s):  
Pabitra Bastola ◽  
Dipendra Kumar Yadav ◽  
Himlal Gautam
Keyword(s):  
Antenatal Care ◽  
Care Service ◽  
Blood Pressure Measurement ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Cross Sectional ◽  
Danger Signs ◽  
Care Services ◽  
Assess Quality

Background: Antenatal care service is an evidence based interventions given to the pregnant women. Objective of the study was to assess quality of antenatal care services in selected health facilities of Kaski district, Nepal.Methods: A cross sectional study was conducted in selected health institutions in Kaski district of Nepal during June to November 2017. Two hundred seven participants were selected from health facilities of Kaski district. Structured questionnaires were employed as tool for data collection.Results: This study showed that 50.7 percent respondents waited less than 35 minutes for receiving service. More than half of the total respondents (63.3%) reported that the consultation time provided for them was less than 20 minutes. All respondents reported that weight and blood pressure measurement was undertaken while none of them reported that height was measured. It was found that maximum number of participants (99.0%) were received iron/folate tablets and tetanus vaccination. Similarly, 97.6% of participants reported that they were counselled on nutrition and 96.6% of reported they get counselling on danger signs. In overall, 48.3% of the respondents were satisfied with the services they received and 43% of the respondents received good quality ANC service from different health institutions.Conclusions: In overall satisfaction of antenatal care services was found to be low and more than half of respondent does not received good quality ANC services.

Health providers’ perception of quality of care for neonates in health facilities in a municipality in Southern Ghana

2016 ◽  
Vol 29 (8) ◽  
pp. 907-920 ◽  
Author(s):  
Kokui Elikplim Pomevor ◽  
Augustine Adomah-Afari
Keyword(s):  
Health Care ◽  
Neonatal Resuscitation ◽  
Neonatal Care ◽  
Health Care Facilities ◽  
Health Facilities ◽  
Health Providers ◽  
Policy Makers ◽  
Content Type ◽  
Southern Ghana

Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers’ perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates’ perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of neonatal health care in health facilities in Ghana and in countries with similar challenges. Social implications The study found that the majority of nursing staff catering for sick newborns were not trained in neonatal nursing. Babies were found sleeping in separate cots but were mixed with older children. The study suggests that babies should be provided with a separate room and not mixed with older babies. Originality/value There seemed to be no defined policy framework for management of neonatal care in the country’s health care facilities. The study recommends the adoption of paediatric and neonatal care nursing as a specialty in the curricula of health training institutions. In-service trainings should encompass issues related to management of sick babies, care of preterm babies, neonatal resuscitation and intravenouscannulation, among others.

scholarly journals Health Facility Capacity to Provide Maternal and Newborn Healthcare Services in Unguja

2019 ◽  
Vol 11 (10) ◽  
pp. 120
Author(s):  
Rukia Rajab Bakar ◽  
Rachel N Manongi ◽  
Blandina T. Mmbaga
Keyword(s):  
Child Health ◽  
Staff Training ◽  
Assessment Tool ◽  
Neonatal Care ◽  
Health Facilities ◽  
Sub Saharan Africa ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Care Services ◽  
And Child Health

Globally, every year 529,000 maternal deaths occur, 99% of which in developing countries with majority being in Sub-Saharan Africa. Maternal, Newborn and Child Health (MNCH) services depend on the accessibility, availability and quality of antenatal care (ANC), delivery and postnatal services. The aim of this study was to assess the health facilities&rsquo; capacity and readiness to provide MNCH services in Unguja Island, Zanzibar. A facility-based cross-sectional survey was conducted from May to June 2015 at public health facilities providing MNCH services. Data was collected by using the modified Service Availability and Readiness Assessment tool. Eighteen health facilities were assessed, two-thirds (66.7%, n = 12) of which were offering both maternity and reproductive and child health (RCH) services, 4 (22.2%) RCH services only, and 2 (11.1%) maternity services only. Readiness score for ANC services was 66% with high readiness scores in diagnostics services (89%) and equipment (69%). Overall, 14% offered all seven signal functions. Overall, delivery service readiness score was 48%. Overall readiness for comprehensive emergency obstetric and neonatal care services was 13%. Staff training and guidelines readiness score was 11%, while medicine and commodities score was 9%. The health facilities&rsquo; readiness in providing MNCH services remains inadequate in Unguja Island. Readiness in providing services was low for delivery and emergency obstetric and neonatal care services. Basic and advanced delivery services need to be improved in parallel with provision of necessary equipment, medicines and commodities and staff training for better MNCH service delivery.

scholarly journals Determinan Komplikasi Obstetri Di Indonesia (Analisis Data SDKI 2012)

2018 ◽  
Vol 9 (2) ◽  
Author(s):  
Seri Laila
Keyword(s):  
Mortality Rate ◽  
Secondary Data ◽  
Obstetric Complication ◽  
Obstetric Complications ◽  
Research Use ◽  
Improve Quality ◽  
Cross Sectional ◽  
Live Births ◽  
History Of

Maternal mortality rate in Indonesia data IDHS on 2012 is still high at 359/100,000 live births, an increase of 57% compared to IDHS in 2007. One cause is due to obstetric complications. Compared to the 2002 and 2007 IDHS data, this figure is increasing and many factors affect the occurrence of obstetric complications. The objective is to know the determinant of obstetric complication based on IDHS data of 2012. This research use secondary data with cross sectional approach based on survey of IDHS 2012 with 4,618 samples. Result: Obstetric complication were 51,2% and there was significant correlation social of economy, parity, distance birth, history of complication, residence area, place of labor and quality of ANC to the obstetric complication. Result of research showed that there were correlation history of complication before OR=4,084, quality of ANC OR=1,187, place of labor OR=1,517, birth and parity spots interact with village residence against obstetric complications.  Expected to improve quality services of ANC and ability of health worker to handle  reference   cases and improving readiness mother and family for recognize and anticipate incident of obstetric complication especially for mother who  are at risk

scholarly journals Health Status and Quality of Health Care Services of Congolese Refugees in Nakivale, Uganda

2016 ◽  
Vol 5 (3) ◽  
pp. 39
Author(s):  
Amegovu K. Andrew
Keyword(s):  
Health Status ◽  
Health Services ◽  
Resource Constraints ◽  
Service Providers ◽  
Geographic Origin ◽  
Health Service Delivery ◽  
Health Facilities ◽  
Cross Sectional ◽  
Adequate Food

Physical and emotional wellness, as well as access to healthcare, are foundations for successful resettlement. Without feeling healthy, it is difficult to work, to go school, or take care of a family. Many factors can affect refugee health, including geographic origin and refugee camp conditions. Refugees may face a wide variety of acute or chronic health issues (Office of Refugee Resettlement, ORR Annual Report to Congress 2014; http://www.acf.hhs.gov). Resettlement of refugees in Uganda is usually supported by concerted efforts of UNHCR, Governments through the Office of the Prime Minister, OPM with support from host communities, local and international Non-Governmental Organizations. Due to resource constraints and local factors, immigrants are often subjected to poor living conditions which coupled with inadequacy inessential medical supplies might significantly affects quality of care and health service delivery and hence, rendering refugees to poor health status. This study was conducted from 2013-2014 to assess the determinants of health status of Congolese refugees living in Nakivale refugee settlement, in Isingiro district- South Western Uganda. A cross-sectional study design was used involving mixed techniques of both qualitative and quantitative KAP survey. The study focussed on Congolese refugee population in Nakivale Refugee settlement. 2401 key informants’ interviews and 8 focus group discussions respectively were conducted targeting service providers and beneficiaries/Congolese refugees in this case. The data was analysed using SPSS ver.20, 2011. Although majority (97%) of respondents sought medical services from established health facilities, findings confirm a high level of ill health prevalence among Congolese refugees in Nakivale camp, however, the difference in health services and perceived health status in camp versus the one in DRcongo is insignificant ( p=0.000) with respondents perceiving their health status as worse than when they were their own Country before the resettlement. Identified key challenges affecting access &amp; uptake of available health services includes: language barrier; inadequate drugs; and the long distances to access health facilities. The health status of refugees could be improved by addressing the challenges related to language, drug supplies in addition to humanising conditions of shelter, providing appropriate waste disposal facilities while proving adequate food rations and clean &amp; safe drinking water.

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