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

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.

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

BMJ Open ◽

10.1136/bmjopen-2017-021431 ◽

2018 ◽

Vol 8 (12) ◽

pp. e021431 ◽

Cited By ~ 2

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.

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

Revista Paulista de Pediatria ◽

10.1590/1984-0462/2021/39/2019334 ◽

2021 ◽

Vol 39 ◽

Author(s):

Rafaella Willig de Quadros ◽

Lara Damiani Cabral ◽

Chaiana Esmeraldino Mendes Marcon ◽

Felipa Daiana Bezerra ◽

Maria Alexsandra da Silva Menezes ◽

...

Keyword(s):

Perinatal Care ◽

Newborn Care ◽

State Structure ◽

Work Processes ◽

Essential Newborn Care ◽

Brazilian State

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

BMJ Open ◽

10.1136/bmjopen-2019-030496 ◽

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.

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Knowledge and practice of essential newborn care among rural mothers

Asian Journal of Medical and Biological Research ◽

10.3329/ajmbr.v6i4.51247 ◽

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

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

BMJ Global Health ◽

10.1136/bmjgh-2020-002581 ◽

2020 ◽

Vol 5 (8) ◽

pp. e002581 ◽

Cited By ~ 1

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.

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Essential newborn care practice and its associated factors in Southwest Ethiopia

Archives of Public Health ◽

10.1186/s13690-021-00568-6 ◽

2021 ◽

Vol 79 (1) ◽

Author(s):

Haimanot Abebe ◽

Daniel Adane ◽

Solomon Shitu

Keyword(s):

Associated Factors ◽

Newborn Care ◽

Care Practice ◽

Framework Analysis ◽

Cross Sectional ◽

Essential Newborn Care ◽

Southwest Ethiopia ◽

The Past ◽

Newborn Care Practice ◽

Pregnant Mothers

Abstract Background Essential newborn care is a wide-ranging strategy intended to improve the health of newborns by implementing appropriate interventions. Approximately in 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7000, newborns every day, with about a third of all neonatal deaths occurring within the first day after birth. Even though the most cause of death is preventable the burden of neonatal death is a still high in developing countries including Ethiopia. Therefore this study is aimed to assess the level of essential newborn care practice among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. Methods A community-based cross-sectional study was conducted among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. For the quantitative part, 624 study participants were involved by using a multi-stage sampling method. A systematic random sampling technique was to reach the study subjects. Data entry was carried out by Epi data version 4.0.0 and analysis was done by SPSS window version 24. Binary and multivariate logistic regressions were used to identify associated factors. For the qualitative part, three focus group discussions (FGD) with purposively selected 30 mothers were involved. The data were analyzed deductively by using the thematic framework analysis approach by using Open code version 4.02. Result Overall good essential newborn care practice was found to be 41.0% [95%CI, 36.6–44.7]. Being urban residence [AOR 1.70, 95%CI: 1.03–2.79], attending antenatal care visit [AOR = 3.53, 95%CI: 2.14–5.83], attending pregnant mothers meeting [AOR = 1.86, 95%CI: 1.21–2.86], had immediate postnatal care [AOR = 3.92, 95% CI: 2.65–5.78], and having good knowledge about ENC [AOR = 2.13, 95% CI: 1.47–3.10] were significantly associated with good essential newborn care practice. Conclusion This study indicated that the magnitude of essential newborn care practice was low. Thus, a primary health care provider should regularly provide ENC for newborns and take opportunities to counsel the mothers about ENC during pregnant mothers meeting and MCH services sessions.

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Essential Newborn Care Among Postnatal Mothers at Selected Health Centers in Eastern Province, Rwanda

Rwanda Journal of Medicine and Health Sciences ◽

10.4314/rjmhs.v3i2.5 ◽

2020 ◽

Vol 3 (2) ◽

pp. 139-151

Author(s):

Miriam Batamuriza ◽

Emmerence Uwingabire ◽

Adejumo Oluyinka

Keyword(s):

Newborn Care ◽

Binary Logistic Regression ◽

World Health ◽

Cord Care ◽

Cross Sectional ◽

Essential Newborn Care ◽

Live Births ◽

Postnatal Mothers ◽

Knowledge And Practice ◽

Evidenced Based

Background Rwanda's neonatal mortality rate is 20/1000 live births, and the country aims to meet the Sustainable Development Goal of 12 deaths per 1000 live births, or less, by 2030. Countries have decreased newborn deaths, infections, and intensive care unit admissions using the evidenced-based 'Essential Newborn Care' (ENC) guidelines established by the World Health Organization. Objective To assess postnatal mothers’ knowledge and practice of Essential Newborn Care in Kayonza District, Rwanda. Method A descriptive cross-sectional design was used to assess 192 postnatal mothers at the six-week vaccination services at two health facilities. Data collection using a valid questionnaire occurred from February 28 to March 2, 2019. Data analysis included descriptive and binary logistic regression. Results The majority (65.1%) had good ENC knowledge and practice, whereas a third (34.9%) had poor knowledge and practice. Significant gaps in ENC included timing of breastfeeding 33(17.2%), cord care 32(16.7%), and thermoregulation of small birth weight newborns 6(3.1%). Significant associations with ENC included maternal age (p=0.003), and ENC education postpartum (p=0.020). Conclusion The overall knowledge and practice of ENC are encouraging in this population, particularly with ENC education given postpartum, and older mothers. However, major gaps included evidenced-based cord care, thermoregulation, and breastfeeding, particularly among younger mothers. Rwanda J Med Health Sci 2020;3(2):139-151

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Community Based Essential New Born Care Practices and Associated Factors among Women in the Rural Community of Awabel District, East Gojjam Zone, Amhara, Ethiopia, 2013

International Journal of Advances in Scientific Research ◽

10.7439/ijasr.v1i1.1637 ◽

2015 ◽

Vol 1 (1) ◽

pp. 17 ◽

Cited By ~ 8

Author(s):

Teshome Kokebie ◽

Mekonen Aychiluhm ◽

Genet Degu Alamneh

Keyword(s):

Rural Women ◽

Associated Factors ◽

Newborn Care ◽

Educational Status ◽

Birth Preparedness ◽

Community Based ◽

Cross Sectional ◽

Essential Newborn Care ◽

New Born ◽

Care Practices

Background; Essential newborn care is important for the proper development and healthy life of a baby. Although 70% of infant deaths occur during the first month of life, the policy-makers and health professionals in developing countries, until recently, gave little attention for the new born care. But, the principles of essential newborn care are simple, requiring no expensive high technology equipment.Objective: the main aim of this study was to assess level of community based essential new born care practices and associated factors among rural women who gave birth in the last 12 months preceding the survey in Awabel District, Amhara, Ethiopia.Method: A community-based cross-sectional study was conducted in September and October 20013. Data were collected from randomly selected 570 women by interview. The collected data were entered into computer using Epi-Data version3.1 and analyzed using SPSS version 16. Logestic regression was fitted to assess possible associations and the strength of association was measured using odds ratio with 95% CI.Results: the study revealed that the level of Essential New born Care practices was 23.1%. Educational status, (OR=7.02, 95%, CI=2.27,21.74), immediate PNC visit, (OR=3.22,95%CI = 1.18,9.48), advise about Essential New born Care practices during monthly pregnant mothers group meeting (OR=4.77,95%CI=1.11, 19.79) advise about birth preparedness during ANC visits (OR=9.05,95% CI =2.76,29.61) and presence of radio in the household (OR=7.91,95%CI=2.64,23.67) were found to have statistically significant association with essential new born care practices.Conclusion: The study identified low comprehensive practices of essential new born care in the study area. Community oriented promotion of essential new born care practices including women empowerment through education, promotion of suitable IEC materials and emphasizing and providing information and education to all pregnant women is recommended.

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Congenital malformations in Rio de Janeiro, Brazil: prevalence and associated factors

Cadernos de Saúde Pública ◽

10.1590/s0102-311x2006001100016 ◽

2006 ◽

Vol 22 (11) ◽

pp. 2423-2431 ◽

Cited By ~ 34

Author(s):

Cláudia Maria da Silva Costa ◽

Silvana Granado Nogueira da Gama ◽

Maria do Carmo Leal

Keyword(s):

Prenatal Care ◽

Congenital Malformations ◽

Rio De Janeiro ◽

Newborn Infants ◽

National Health System ◽

Childbearing Age ◽

Cross Sectional ◽

Maternity Hospitals ◽

Childbearing Age Women ◽

Inadequate Prenatal Care

This study aims to estimate the prevalence of congenital malformations and their correlation with socioeconomic and maternal variables. The design was cross-sectional, based on a sample of 9,386 postpartum women after admission for childbirth in maternity hospitals in the city of Rio de Janeiro, Brazil. Data were collected through interviews with mothers in the immediate postpartum, as well as by consulting the patient records of both the mothers and newborn infants. Prevalence of congenital malformations at birth was 1.7%, and minor malformations were the most frequent. Neural tube defects were the most frequent major malformations. According to multivariate analysis, congenital malformations were statistically associated with: maternity hospitals belonging to or outsourced by the Unified National Health System (SUS) and inadequate prenatal care (¾ 3 visits). This study highlights the importance of measures for health promotion and disease prevention in childbearing-age women, with special attention to prenatal care and childbirth, which can directly influence neonatal indicators and prevention of birth defects.

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