scholarly journals Health facility structure and maternal characteristics related to essential newborn care in Brazil: a cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e021431 ◽  
Author(s):  
Maria Alexsandra Silva Menezes ◽  
Ricardo Gurgel ◽  
Sonia Duarte Azevedo Bittencourt ◽  
Vanessa Eufrazino Pacheco ◽  
Rosana Cipolotti ◽  
...  
Keyword(s):  
Health Facility ◽  
Breast Feeding ◽  
Perinatal Care ◽  
Newborn Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Skin Contact ◽  
Postnatal Women ◽  
Skin To Skin

ObjectivesTo assess the use of the WHO’s Essential Newborn Care (ENC) programme items and to investigate how the non-use of such technologies associates with the mothers' characteristics and hospital structure.DesignA cross-sectional observational health facility assessment.SettingThis is a secondary analysis of the ‘Birth in Brazil’ study, a national population-based survey on postnatal women/newborn babies and of 266 publicly and privately funded health facilities (secondary and tertiary level of care).ParticipantsData on 23 894 postnatal women and their newborn babies were analysed.Main outcome measuresThe facility structure was assessed by evaluating the availability of medicines and equipment for perinatal care, a paediatrician on call 24/7, a neonatal intensive care unit (NICU) and kangaroo mother care. The use of each ENC item was assessed according to the health facility structure and the mothers’ sociodemographic characteristics.ResultsThe utilisation of ENC items is low in Brazil. The factors associated with failure in pregnant woman reference were: pregnant adolescents (ORadj1.17; 95% CI 1.06 to 1.29), ≤7 years of schooling (ORadj1.47; 95% CI 1.22 to 1.78), inadequate antenatal care (ORadj1.67; 95% CI 1.47 to 1.89). The non-use of corticosteroids was more frequently associated with the absence of an NICU (ORadj3.93; 95% CI 2.34 to 6,66), inadequate equipment and medicines (ORadj2.16; 95% CI 1.17 to 4.01). In caesarean deliveries, there was a less frequent use of a partograph (ORadj4,93; 95% CI 3.77 to 6.46), early skin-to-skin contact (ORadj3.07; 95% CI 3.37 to 4.90) and breast feeding in the first hour after birth (ORadj2.55; 95% CI 2.21 to 2.96).ConclusionsThe coverage of ENC technologies use is low throughout Brazil and shows regional differences. We found a positive effect of adequate structure at health facilities on antenatal corticosteroids use and on partograph use during labour. We found a negative effect of caesarean section on early skin-to-skin contact and early breast feeding.

scholarly journals Quality of essential newborn care and neonatal resuscitation at health facilities in Afghanistan: a cross-sectional assessment

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030496
Author(s):  
Faridullah Atiqzai ◽  
Partamin Manalai ◽  
Sher Shah Amin ◽  
Karen M Edmond ◽  
Malalai Naziri ◽  
...  
Keyword(s):  
Public Health ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
High Volume ◽  
Health Facilities ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Public Health Facilities ◽  
Skin Contact

ObjectiveTo assess readiness and quality of essential newborn care and neonatal resuscitation practices in public health facilities in Afghanistan.DesignCross-sectional assessment.Setting226 public health facilities in Afghanistan, including 77 public health facilities with at least five births per day (high-volume facilities) and 149 of 1736 public health facilities with fewer than five births per day (low-volume facilities).ParticipantsManagers of 226 public health facilities, 734 skilled birth attendants (SBAs) working at these facilities, and 643 women and their newborns observed during childbirth at 77 high-volume health facilities.Outcome measuresAvailability of knowledgeable SBAs, availability of supplies and compliance with global guidelines for essential newborn care and neonatal resuscitation practices.ResultsAt high-volume facilities, 569/636 (87.9%) of babies were dried immediately after birth, 313/636 (49.2%) were placed in skin-to-skin contact with their mother and 581/636 (89.7%) had their umbilical cord cut with a sterile blade or scissors. A total of 87 newborn resuscitation attempts were observed. Twenty-four of the 87 (27.5%) began to breath or cry after simply clearing the airway or on stimulation. In the remaining 63 (72.5%) cases, a healthcare worker began resuscitation with a bag and mask; however, only 54 (62%) used a correct size of mask and three babies died as their resuscitation with bag and mask was unsuccessful.ConclusionsThe study indicates room for improvement of the quality of neonatal resuscitation practices at public health facilities in Afghanistan, requiring only strengthening of the current best practices in newborn care. Certain basic and effective aspects of essential newborn care that can be improved on with little additional resources were also missing, such as skin-to-skin contact of the babies with their mother. Improvement of compliance with the standard newborn care practices must be ensured to reduce preventable newborn mortality and morbidity in Afghanistan.

scholarly journals PERINATAL CARE IN A NORTHEASTERN BRAZILIAN STATE: STRUCTURE, WORK PROCESSES, AND EVALUATION OF THE COMPONENTS OF ESSENTIAL NEWBORN CARE

2019 ◽  
Vol 37 (2) ◽  
pp. 140-148
Author(s):  
Felipa Daiana Bezerra ◽  
Maria Alexsandra da Silva Menezes ◽  
Rosemar Barbosa Mendes ◽  
José Marcos de Jesus Santos ◽  
Débora Cristina Fontes Leite ◽  
...  
Keyword(s):  
Perinatal Care ◽  
Newborn Infants ◽  
Newborn Care ◽  
Risk Classification ◽  
Capital City ◽  
Work Processes ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Skin Contact ◽  
Maternity Hospitals

ABSTRACT Objective: To describe the structure and the processes of care for pregnant women/newborn infants, including the Essential Newborn Care (ENC), in maternity hospitals in Sergipe State, Brazil. Methods: A cross-sectional study carried out between June 2015 and April 2016 in all maternity hospitals of Sergipe with more than 500 deliveries/year (n=11). A questionnaire on the existing structure and work processes was administered to the managers. Subsequently, a representative number of postpartum women from these hospitals were interviewed (n=768). Their medical records, as well as newborn infants’ records, were also analyzed. Results: Sergipe has 78 beds of Neonatal Intensive Care Unit (NICU) and 90 beds of Intermediate Care Unit (IMCU) to meet spontaneous and programmed demand. Only six maternity hospitals (54.5%) performed the risk classification, and four (36.3%) had protocols for high-risk parturient care. Regarding the ENC components, only 41% (n=315) of the women had early skin-to-skin contact with their babies, 33.1% (n=254) breastfed in the first hour of life, and 18% (n=138) had a companion always during birth. Conclusions: The distribution of NICU beds between capital city and other cities of the State is adequate, considering Brazilian guidelines. However, there was a low adherence to the protocols for hypertensive and hemorrhagic emergencies, and a low coverage of humanization policies, pregnancy risk classification and ENC practices, especially breastfeeding in the first hour of life, and companion always during birth.

scholarly journals Knowledge and practice of essential newborn care among rural mothers

2021 ◽  
Vol 6 (4) ◽  
pp. 785-794
Author(s):  
Mst Beauty Begum ◽  
China Rani Mittra ◽  
Ashees Kumar Shaha ◽  
Priti Lata Mondal ◽  
Kamarun Naher ◽  
...  
Keyword(s):  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Care Seeking ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
New Born ◽  
Skin Contact ◽  
Inadequate Knowledge ◽  
Knowledge And Practice ◽  
Rural Mothers

Components of essential newborn care (ENC) and neonatal resuscitation are proven interventions for reducing neonatal mortality rate and stillbirth rates. This cross-sectional study was carried out among 354 rural mothers to assess the level of knowledge and practice of ENC. The study was conducted from 1st January to 31st December 2019 in Panchagarh district. Rural mothers were interviewed with a semi-structured pre-tested questionnaire and an observational check list was also used. This study revealed that, majority of the respondents 306 (86.4%) knew that baby should be kept warmth by wrapping with dry cloth and 39(11.0%) respondents should be kept in skin to skin contact immediately after delivery to maintain thermoregulation. From the total respondents 202 (57.1 %) knew that once should start breast feeding immediately after birth. Out of 354 respondents 344 (97.2%) gave colostrum to their baby. The study also finds that, 210 (59.3%) respondents had inadequate knowledge regarding essential new born care while 144 (40.7%) had adequate knowledge and 164 (46.3%) respondents had inadequate practice regarding essential new born care while 190 (53.7%) had adequate practice. Respondents who had inadequate knowledge had significantly more inadequate practice than others (p<0.001). Effective interventions can improve key newborn care practices, care-seeking and, in high mortality settings, reduce newborn mortality. Asian J. Med. Biol. Res. December 2020, 6(4): 785-794

scholarly journals Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

2020 ◽  
Author(s):  
Binyam Fekadu Desta ◽  
Ismael Ali Beshir ◽  
Zergu Tafesse ◽  
Hailemariam Segni
Keyword(s):  
Logistic Regression ◽  
Health Facility ◽  
Health Workers ◽  
Multiple Logistic Regression Analysis ◽  
Newborn Care ◽  
Outcome Variable ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Delivery Rooms

Abstract Background: Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Although a minimum package of proven interventions to reduce newborn mortality have been adopted, countries are still challenged by multiple system related problems. Methods: This study employed a retrospective cross-sectional study design and used program monitoring data collected from 425 facilities between October and December 2019. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p<0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results: A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors - availability of essential obstetrics drugs in delivery rooms, high CSC performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of CD-ENC was consistent partograph use, recording an odds ratio of 2.66. Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 times higher odds of exhibiting consistent delivery of ENC. Conclusion: Health worker commitment to provide ENC is linked to the practices and platforms created by health facility management. Health facility managers should establish a platform or mechanism to enhance providers relationship with their clients as well as comprehensive tools to remind health workers’ responsibilities with regards to ENC. In addition, the health service managers should also consider availing the required supplies and drugs closer to the service delivery rooms and tables.

scholarly journals Knowledge of Essential Newborn Care and Associated Factors among Nurses and Midwives: A Cross-Sectional Study at Public Health Facilities in Wolaita Zone, Southern Ethiopia, 2019

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Aseb Arba ◽  
Zerihun Zana
Keyword(s):  
Public Health ◽  
Newborn Care ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Public Health Facilities ◽  
Delivery Unit ◽  
Nurses And Midwives

Background. Knowledge of essential newborn care and proper practice is important for the survival, growth, and development of a newborn. In spite of its essentiality, most health-care professionals do not know and follow the World Health Organization recommendation. Therefore, this study is aimed at assessing knowledge of essential newborn care and associated factors among nurses and midwives working in maternal health case team at public health facilities of Wolaita Zone, Ethiopia, 2019. Methods. Institution-based cross-sectional study design was conducted from March to April 2019. Data were collected by using pretested questionnaire, and 36 public health facilities were selected after stratifying them based on their level of service and number of nurses and midwives working in maternal health-care team. All 218 nurses and midwives who were working in the delivery unit from selected facilities were included in the study. The collected data were entered into Epi data 3.02 and exported to statistical software for social sciences version 22 for analysis. Descriptive, bivariate, and multivariate analyses were done. Statistical significance of variables was declared as a p value<0.05, and strength of association was adjusted odds ratio at 95% confidence interval in the final model. Result. A total of 218 nurses and midwives were participated in the study. Among them, 57.9% of participants had good knowledge of essential newborn care. The type of profession (AOR=5.79, [2.47, 13.58]), educational level (AOR=3.26, [1.42, 7.52]), interest to work in delivery room (AOR=4.85, [1.89, 12.42]), and presence of guidelines (AOR=2.29, [1.18, 4.45]) were the factors significantly associated with having knowledge of essential newborn care. Conclusion and Recommendation. The nurses and midwives had poor knowledge of some components of essential newborn care in the study area. Bachelor level of study, interest to work in delivery room, and being a midwife were the factors independently associated with knowledge of essential newborn care among nurses and midwives. Therefore, the head of labor ward and institution, zonal and woreda health units, and nongovernmental organizations who are working on maternal and child health should work on providing continuous education, providing incentives and motivators to improve interest to work in delivery unit, and providing guidelines in the unit.

scholarly journals 65 Mama na Mtoto: Health Outcome Achievements Following Implementation of Comprehensive Maternal Newborn Programming in Rural Tanzania

2020 ◽  
Vol 25 (Supplement_2) ◽  
pp. e27-e27
Author(s):  
Jennifer L Brenner ◽  
Dismas Matovelo ◽  
Boniphace Maendaelo ◽  
Wemaeli Mweteni ◽  
Nalini Singhal ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Health Facility ◽  
Postnatal Care ◽  
Health Workers ◽  
Scale Up ◽  
Newborn Care ◽  
Health Facilities ◽  
Care Seeking ◽  
Essential Newborn Care ◽  
Facility Readiness

Abstract Introduction/Background Preventable deaths in pregnant women and newborns remain unacceptably high in East Africa. Limited antenatal, delivery and postnatal care-seeking combined with service delivery gaps at government facilities contribute to high mortality. Between 2016-2019, partners from Tanzania, Uganda, and Canada jointly developed, implemented, and evaluated a comprehensive, district-wide maternal, newborn, and child health (MNCH) ‘package’ in Lake Zone, Tanzania. Known locally as ‘Mama na Mtoto’, the scale-up programming involved training and capacity building for district managers, health facility staff and a network of volunteer community health workers selected by their own communities. Objectives To quantitatively assess changes in MNCH health outcomes following the Mama na Mtoto intervention. Design/Methods MNCH household-level care-seeking outcomes were assessed using a pre/post coverage survey adapted from the Demographic Health Survey. Households and women (15-49 years), selected through cluster sampling (cluster unit=hamlet), were surveyed by local, trained research assistants using tablet-based surveys. MNCH service outcomes were assessed at all government health facilities using a comprehensive pre/post cross-sectional audit tool; key measures included staff, equipment, infrastructure, supplies, and medication availability. Descriptive statistics for antenatal care (ANC), health facility delivery (HFD), and postnatal care (PNC)-related indicators were analyzed pre- and post-intervention using R software. Composite health facility ‘Readiness Scores’ were calculated through tallies of relevant itemized facility-based measures for each core MNCH service area across the district. Absolute percentage differences, confidence intervals and design effect are presented where relevant. Results In total, 1,977 households, 2,438 women, and 45 health facilities were surveyed pre-intervention and 1,835 homes, 2,073 women, and 49 health facilities were surveyed post. Care-seeking indicators with statistically significant changes were ANC 4+ (+11%), ANC &lt;12 weeks (+7%), HFD (+17%), and PNC for mothers (+9%); PNC for babies was not significant. Increases in composite MNCH Service Readiness Scores were as follows: ANC +24%, essential newborn care +42%, newborn resuscitation +37%, and labour and delivery +27%. Conclusion The comprehensive MnM package was associated with important improvements in the demand (care-seeking) and service (facility readiness) health outcomes. Attribution is complicated by an uncontrolled health system and lack of district controls; however, the extensive scope, reach, and positive changes are promising and consistent with sustained Ugandan experiences. Best practice documentation is critical to facilitate scale-up and progress acceleration of MNCH programs in Tanzanian and East African settings.

scholarly journals Association between early essential newborn care and breastfeeding outcomes in eight countries in Asia and the Pacific: a cross-sectional observational -study

2020 ◽  
Vol 5 (8) ◽  
pp. e002581 ◽  
Author(s):  
Zhao Li ◽  
Priya Mannava ◽  
John Charles Scott Murray ◽  
Howard Lawrence Sobel ◽  
Annie Jatobatu ◽  
...  
Keyword(s):  
Observational Study ◽  
Newborn Care ◽  
Delivery Mode ◽  
Breastfeeding Initiation ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Environmental Interventions ◽  
Policy Practice ◽  
Skin Contact ◽  
The Pacific

ObjectiveTo explore the association between early essential newborn care (EENC) policy, practice and environmental interventions and breastfeeding outcomes.DesignCross-sectional observational study.Setting150 national, provincial and district hospitals implementing EENC in eight countries in East Asia and the Pacific.Participants1383 maternal interviews, chart reviews and environmental assessments during 2016 and 2017.Main outcome measuresExclusive breastfeeding (EBF), that is, feeding only breastmilk without other food or fluids since birth and before discharge, and, early breastfeeding initiation, that is, during skin-to-skin contact (SSC) with the mother without separation.ResultsFifty-nine per cent of newborns initiated breastfeeding early and 83.5% were EBF. Duration of SSC showed a strong dose–response relationship with early breastfeeding initiation. SSC of at least 90 min was associated with 368.81 (95% CI 88.76 to 1532.38, p<0.001) times higher early breastfeeding. EBF was significantly associated with SSC duration of 30–59 min (OR 3.54, 95% CI 1.88 to 6.66, p<0.001), 60–89 min (OR 5.61, 95% CI 2.51 to 12.58, p<0.001) and at least 90 min (OR 3.78, 95% CI 2.12 to 6.74, p<0.001) regardless of delivery mode. Non-supine position (OR 2.80, 95% CI 1.90 to 4.11, p<0.001), rooming-in (OR 5.85, 95% CI 3.46 to 9.88, p<0.001), hospital breastfeeding policies (OR 2.82, 95% CI 1.97 to 4.02, p<0.001), quality improvement mechanisms (OR 1.63, 95% CI 1.07 to 2.49, p=0.02) and no formula products (OR 17.50, 95% CI 5.92 to 51.74, p<0.001) were associated with EBF.ConclusionEENC policy, practice and environmental interventions were associated with breastfeeding outcomes. To maximise the likelihood of early and EBF, newborns, regardless of delivery mode, should receive immediate and uninterrupted SSC for at least 90 min.

scholarly journals Prevalence and factors associated with skin-to-skin contact (SSC) practices: findings from a population-based cross-sectional survey in 10 selected districts of Bangladesh

2021 ◽  
Author(s):  
Nazia Binte Ali ◽  
Sabrina Sharmin Priyanka ◽  
Bal Ram Bhui ◽  
Samantha Herrera ◽  
Md. Rashidul Azad ◽  
...  
Keyword(s):  
Multivariable Analysis ◽  
Newborn Care ◽  
Positive Association ◽  
Facility Delivery ◽  
Public Facility ◽  
Significant Positive Association ◽  
Essential Newborn Care ◽  
Factors Associated ◽  
Skin Contact ◽  
Skin To Skin

Abstract Background: Skin-to-skin contact (SSC) is one of the eight proven Essential Newborn Care (ENC) practices that improve newborn survival. Despite having myriads of benefits, it is one of the least used ENC interventions especially in the low and middle-income countries (1% to 74%). In Bangladesh, the prevalence of SSC practices was 26% in 2014. To advance the use of this intervention, it is important to assess its prevalence within the population and to identify factors that facilitate or inhibit SSC practices in Bangladesh. Methods: We used baseline household survey data of USAID’s MaMoni MNCSP project conducted in 10 districts of Bangladesh in 2019. Our analysis included 13,695 recently delivered women (RDW) with a live birth outcome. Our primary outcome was the mother’s reported SSC practice. We examined various antepartum, intrapartum, newborn, and sociodemographic factors associated with SSC using a multivariable generalized linear model. Our findings were reported using adjusted Prevalence Risk Ratios (aPRRs) and 95% Confidence Intervals (CIs). Results: Overall, 28% of RDW reported practicing SSC across the 10 surveyed districts. Our multivariable analysis showed that public facility delivery (aPRR 2.01; 95%CI: 1.80, 2.26), private facility delivery (aPRR 1.23; 95%CI: 1.06, 1.42) and 4 antenatal care (ANC) visits at least one from a medically trained provider (MTP) (aPRR 1.17; 95%CI: 1.03, 1.26) had a significant positive association with SSC practices. Caesarean section (aPRR 0.64; 95%CI: 0.56, 0.73) had a significant negative association with SSC practices. We also found a significant positive association of SSC practices with mothers’ who perceived the birth size of their baby to be small, mothers with a higher education level (≥10 years), and mothers from households in the highest wealth quintile. Conclusions: The prevalence of SSC is very low in the surveyed districts of Bangladesh. Considering the factors associated with SSC, relevant stakeholders need to increase their efforts on improving ANC and facility delivery coverages as well as improving SSC practices in the facilities especially after caesarean deliveries. Countries with a high burden of home deliveries also need to emphasize community-based interventions and increasing coverage of skilled birth attendance for improving this life-saving intervention.

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