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 ◽  
...  

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.

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Aseb Arba ◽  
Zerihun Zana

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.


2015 ◽  
Vol 8 (1) ◽  
pp. 24251 ◽  
Author(s):  
Peter Waiswa ◽  
Joseph Akuze ◽  
Stefan Peterson ◽  
Kate Kerber ◽  
Moses Tetui ◽  
...  

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 ◽  
...  

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.


2019 ◽  
Author(s):  
Kiros Fenta Ajemu ◽  
Alem Desta

Abstract Background Substantial improvements have been observed in coverage and access to maternal health services in Ethiopia. However, quality of care has been lagging behind. Therefore, the aim of the study was to assess quality of OptionB + in Mekelle Zone, Northern Ethiopia.Methods Facility based cross-sectional study involving both quantitative and qualitative methods was conducted from December 2016- January 2017. The quality of service delivery was assessed in 11 public health facilities in Mekelle. Data collection was conducted using facility audit, observation, and client exit interview check list to assess (Input-Process–Output) quality components. Similarly in-depth interview guide was used to gather qualitative data. Data were analyzed using SPSS version 21 software. Descriptive statistics were computed to summarize the study findings and triangulation was made with qualitative findings.Results Overall, 2 (16.7%) of study health facilities full filled all the three quality components but none in 3(25%). The input quality component was better than the others in which 4(33.3%) facilities were rated as good. The process and output quality components were judged as good in 3(25%) study health facilities.Conclusion Only 16.7% of facilities studied were achieved good quality with respect to the three predetermined quality components. Since, assessed items in each quality component were potentially easy to intervene; strengthening program monitoring needed by program managers at each level of the health facilities.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramesh Kumar ◽  
Jamil Ahmed ◽  
Fozia Anwar ◽  
Ratana Somrongthong

Abstract Background Basic and comprehensive emergency obstetric care services in Pakistan remain a challenge considering continued high burden of maternal and newborn mortality. This study aimed to assess the availability of emergency obstetric and newborn care in Sindh Province of Pakistan. Methods This cross-sectional survey was conducted in twelve districts of the Sindh province in Pakistan. The districts were selected based on the maternal neonatal and child health indicators. Data were collected from 63 public-sector health facilities including district, Taluka (subdistrict) headquarters hospitals and rural health centers. Basic and comprehensive emergency obstetric newborn care services were assessed through direct observations and interviews with the heads of the health facilities by using a World Health Organization pretested and validated data collection tool. Participants interviewed in this study included the managers and auxiliary staff and in health facilities. Results Availability of caesarean section (23, 95% C.I. 14.0–35.0) and blood transfusion services (57, 95% CI. 44.0–68.0), the two components of comprehensive emergency obstetric and newborn care, was poor in our study. However, assessment of the seven components of basic emergency obstetric and newborn services showed that 92% of the health facilities (95% C.I. 88.0–96.0) had parenteral antibiotics, 90%, (95% C.I. 80.0–95.0) had oxytocin, 92% (95% CI 88.0–96.0) had manual removal of the placenta service, 87% (95%, C.I. 76.0–93.0) of the facilities had staff who could remove retained products of conception, 82% (95% C.I. 71.0–89.0) had facilities for normal birth and 80% (95% C.I. 69.0–88.0) reported presence of neonatal resuscitation service. Conclusion Though the basic obstetric and newborn services were reasonably available, comprehensive obstetric and newborn services were not available as per the World Health Organization’s standards in the surveyed public health facilities. Ensuring the availability of caesarean section and blood transfusion services within these facilities may improve population’s access to these essential services around birth.


2021 ◽  
Vol 6 (4) ◽  
pp. 785-794
Author(s):  
Mst Beauty Begum ◽  
China Rani Mittra ◽  
Ashees Kumar Shaha ◽  
Priti Lata Mondal ◽  
Kamarun Naher ◽  
...  

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


2021 ◽  
Vol 18 (4) ◽  
pp. 644-648
Author(s):  
Khem Bahadur Karki ◽  
Neelam Dhakal ◽  
Baburam Humagain ◽  
Arpana Pandit ◽  
Trishna Acharya ◽  
...  

Background: Poor quality drugs result minor to detrimental effect on human health. The drug should be of standard quality and should be used appropriately in order to meet its therapeutic efficacy. This study aims to assess the quality of drug in Nepal. Methods: A cross sectional study was conducted in randomly selected 88 health facilities in Nepal from 10th April to 30th June 2016. Selective medicines were collected from both private licensed pharmacies and selected public health facilities. Face to face interview with health facility in-charge of selected health facilities was carried out along with the direct observation of the medicine storage room. The collected medicine samples were dispatched to two laboratories for in-vitro analysis. The labels of the collected medicine were analyzed. The obtained data were entered in Epidata version 3.1, cleaned in Microsoft excel 2007 and analyzed in SPSS version 20.Results: Out of 172 brands, nine brands of medicines were found substandard. Information regarding storage conditions, direction for use and category of the drug were lacking in the label of some brands of medicines. Some selected health facilities were found not meeting major requirements for drug storage: protection from sunlight, moisture, heat, well ventilation and proper sanitation.Conclusions: Few drugs were found to be substandard in Nepalese market from both public and private sectors. Adequate labeling and proper storage condition of medicines in health facilities were lacking.Keywords: Drug quality; private pharmacies; public health facilities; substandard drugs.


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