scholarly journals Health facility service availability and readiness to provide basic emergency obstetric and newborn care in a low-resource setting: evidence from a Tanzania National Survey

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e020608 ◽  
Author(s):  
Deogratius Bintabara ◽  
Alex Ernest ◽  
Bonaventura Mpondo
Keyword(s):  
Quality Assurance ◽  
Health Facility ◽  
Newborn Care ◽  
Service Availability ◽  
Signal Functions ◽  
Low Resource ◽  
Care Services ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Maternal And Newborn

ObjectiveThis study used a nationally representative sample from Tanzania as an example of low-resource setting with a high burden of maternal and newborn deaths, to assess the availability and readiness of health facilities to provide basic emergency obstetric and newborn care (BEmONC) and its associated factors.DesignHealth facility-based cross-sectional survey.SettingWe analysed data for obstetric and newborn care services obtained from the 2014–2015 Tanzania Service Provision Assessment survey, using WHO-Service Availability and Readiness Assessment tool.Primary and secondary outcome measuresAvailability of seven signal functions was measured based on the provision of ‘parental administration of antibiotic’, ‘parental administration of oxytocic’, ‘parental administration of anticonvulsants’, ‘assisted vaginal delivery’, ‘manual removal of placenta’, ‘manual removal of retained products of conception’ and ‘neonatal resuscitation’. Readiness was a composite variable measured based on the availability of supportive items categorised into three domains: staff training, diagnostic equipment and basic medicines.ResultsOut of 1188 facilities, 905 (76.2%) were reported to provide obstetric and newborn care services and therefore were included in the analysis of the current study. Overall availability of seven signal functions and average readiness score were consistently higher among hospitals than health centres and dispensaries (p<0.001). Furthermore, the type of facility, performing quality assurance, regular reviewing of maternal and newborn deaths, reviewing clients’ opinion and number of delivery beds per facility were significantly associated with readiness to provide BEmONC.ConclusionThe study findings show disparities in the availability and readiness to provide BEmONC among health facilities in Tanzania. The Tanzanian Ministry of Health should emphasise quality assurance efforts and systematic maternal and newborn death audits. Health leadership should fairly distribute clinical guidelines, essential medicines, equipment and refresher trainings to improve availability and quality BEmONC.

scholarly journals Nursing Care of Low-Risk Newborns in Low Resource Setting: Nurses' Aides May Bridge the Gap at Community Hospitals

2022 ◽  
Vol 3 (1) ◽  
pp. 1-4
Author(s):  
Subhashchandra Daga
Keyword(s):  
Nursing Staff ◽  
Health Workers ◽  
Newborn Care ◽  
Low Resource Settings ◽  
Neonatal Deaths ◽  
Low Resource ◽  
General Duty ◽  
Care Services ◽  
Resource Setting ◽  
Low Resource Setting

Objective: To study the role of a nurses' aide in the care for newborns weighing between 1500 and 2000 g at birth in a low resource setting. Study Design: Observational. Setting: The General hospital in 1994-95, in a public sector, located in a remote area in India Intervention: A female ward assistant with seven years of schooling trained, on-the-job, to keep babies warm, initiate maternal breastfeeding, and to detect rapid breathing. The nursing staff from the pediatric ward supervised her performance. A separate "warm room" appropriately heated for preterm and sick babies became a makeshift nursery. The nursing staff administered enteral feeding, oxygen, and antibiotics. Services of the resident doctors or general duty medical officers were not available. Results: The survival rate was nearly 100% for babies with birthweights between 1,500 and 2,000 g (none referred out). Conclusions: A nurses' aide may facilitate the delivery of special care for newborns where nursing personnel are grossly inadequate and saving babies weighing between 1,500 and 2,000 g may need minimal inputs. It may be worthwhile to target 1,500 and 2,000 g birthweight categories even when resources are meager. What is already known about this subject? Low resource settings face staff shortages, especially nursing staff. Health workers with midwifery skills can deliver nearly 90% of essential care services for maternal and neonatal health. A substantial proportion of neonatal deaths occur among moderately low birth weight babies. What does this study add? It is possible to train a semi-literate person to facilitate early breastfeeding and to keep a baby warm. A large proportion of deaths among babies with birthweight ranging from 1500 to 2000 g are preventable with meager resources. How might this impact on clinical practice or future developments? The facilities facing shortage of nursing staff in low resource settings, may employ nurses’ aide to deliver basic newborn care.

scholarly journals Simulation and team training embedded nurse mentoring programme and improvement in intrapartum and newborn care in a low-resource setting in Bihar, India

2020 ◽  
Vol 10 (2) ◽  
Author(s):  
Rakesh Ghosh ◽  
Hilary Spindler ◽  
Jessica Dyer ◽  
Amelia Christmas ◽  
Susanna R Cohen ◽  
...  
Keyword(s):  
Newborn Care ◽  
Team Training ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting

scholarly journals Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal

2019 ◽  
Vol 24 (S1) ◽  
pp. 31-38 ◽  
Author(s):  
Ashish KC ◽  
Dipendra Raman Singh ◽  
Madan Kumar Upadhyaya ◽  
Shyam Sundar Budhathoki ◽  
Abhishek Gurung ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Health Facility ◽  
Newborn Care ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Health Facilities ◽  
Care Services ◽  
Quality Of Delivery ◽  
Maternal And Newborn

Abstract Introduction Nepal has pledged to substantially reduce maternal and newborn death by 2030. Improving quality of intrapartum health services will be vital to reduce these deaths. This paper examines quality of delivery and newborn services in health facilities of Nepal. Methods Data were sourced from the Nepal Health Facility Survey 2015, which covered a national representative sample of health facilities. The datasets were analysed to assess service readiness, availability and quality of delivery and newborn care in a sample of 992 health facilities. Results Of the 992 facilities in the sample, 623 provided delivery and newborn care services. Of the 623 facilities offering delivery and newborn care services, 13.3% offered comprehensive emergency obstetric care (CEmONC), 19.6% provided basic emergency obstetric care (BEmONC) and 53.9% provided basic delivery and newborn service. The availability of essential equipment for delivery and newborn care was more than 80% in health facilities. Except for the coverage of vitamin K injection, the coverage of immediate newborn care was more than 85% in all health facilities. The coverage of use of chlorhexidine ointment to all newborns was more than 70% in government hospitals and primary health care centers (PHCCs) and only 32.3% in private hospitals. Conclusions These findings show gaps in equipment and drugs, especially in PHCCs and private health facilities. Improving readiness and availability of equipment and drugs in PHCCs and private health facility will help improve the quality of care to further reduce maternal and newborn mortality in Nepal.

scholarly journals Public health facility resource availability and provider adherence to first antenatal guidelines in a low resource setting in Accra, Ghana

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Mary Amoakoh-Coleman ◽  
Irene Akua Agyepong ◽  
Gbenga A. Kayode ◽  
Diederick E. Grobbee ◽  
Kerstin Klipstein-Grobusch ◽  
...  
Keyword(s):  
Public Health ◽  
Health Facility ◽  
Resource Availability ◽  
Public Health Facility ◽  
Low Resource ◽  
Resource Setting ◽  
Low Resource Setting ◽  
Provider Adherence

Determinants of health facilities to provide newborn care services in Ethiopia: Finding from service Availability and Readiness Assessment 2018

2020 ◽  
Author(s):  
Tefera Taddele Tesema
Keyword(s):  
Care Service ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Health Facilities ◽  
Service Availability ◽  
Readiness Assessment ◽  
Signal Functions ◽  
Care Services ◽  
Health Centres ◽  
The Mean

Abstract Background : Almost 50% of under-five mortality happens during the neonatal period. Sub-Saharan Africa has the highest rates of neonatal mortality. In this study we assessed the availability and readiness of health facility for newborn care service, its variations by health facility type, managing authority, location and regions in Ethiopia. Method: Data were used from the 2018 Ethiopian Service Availability and Readiness Assessment (SARA) from 9 regions and two city administration of the country. The overall newborn care services readiness score was calculated using ten tracer items and its mean availability was created for measuring health facilities overall capacity to provide newborn care services. A multiple linear regression model was used to determine factors associated with the newborn health readiness score. The analysis was done using SPSS version 20 and STATA version 14. Result : A total of 632 health facilities were included in the analysis. The mean availability of newborn care services at a national level was 63%. Only 7% of clinics provided neonatal resuscitation. A higher proportion of public facilities provided all signal functions compared with others facility types. Availability of newborn care services in overall facilities found in Tigray region were higher than facilities found in other regions. The overall newborn readiness score for health centres and clinics were lower than hospitals respectively. The expected value of newborn care readiness to provide the service was lower in health facilities found in Oromiya, Somali and Gambella than health facilities in Tigray. Conclusion : The availability of neonatal resuscitation, corticosteroids, antibiotic for preterm or prolonged premature rupture of membrane and injectable antibiotics for sepsis signal functions and the capacity of health facilities in terms of the mean availability of ten tracer items to provide newborn care services were low in clinics compared with health centres and hospitals. There was regional variation on the availability of the services. So, in the future focus should be given on clinics and the regions whose readiness score was low to ensure equity in distribution and its newborn care service capacity.

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