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.

scholarly journals Availability of emergency obstetric and newborn care services at public health facilities of Sindh province in Pakistan

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ramesh Kumar ◽  
Jamil Ahmed ◽  
Fozia Anwar ◽  
Ratana Somrongthong
Keyword(s):  
Public Health ◽  
Caesarean Section ◽  
Blood Transfusion ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Health Facilities ◽  
World Health ◽  
Public Health Facilities ◽  
Care Services ◽  
Sindh Province

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.

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.

The Quality of Service Provision to Newborns in the Primary Healthcare, West Gojjam Zone, North-West of Ethiopia: A Cross-sectional Survey

2021 ◽  
Author(s):  
Bizuhan Gelaw Birhanu ◽  
Johanna Mmabojalwa Mathibe-Neke
Keyword(s):  
Rural Health ◽  
Health Workers ◽  
Newborn Care ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Signal Functions ◽  
Rural Health Centres ◽  
Health Centres

Abstract Background: During 2019, neonatal conditions in Ethiopia accounted for 56% of under-5 deaths, with 33 neonatal deaths occurring for every 1,000 live births. More than 80% of all newborns deaths are caused by preventable and treatable conditions with available interventions. In Ethiopia, mortality rates for newborn babies have remained stubbornly high over the decades. Methods: A cross-sectional survey design was employed. Interviewer-administered questionnaires were administered to 221 health workers and health extension workers in 142 health facilities from April to July 2017. Data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. Results: Out of the ten quality of newborn care variables, 8.7 [95%CI: 6.03-11.303], the highest mean was achieved by primary hospitals, followed by urban health centres with a 6.4 mean [95%CI:5.168-7.601]. However, nearly half of the rural health centres were providing quality of newborn care at the mean of 5.7 [95%CI: 5.152-6.18], and below half was provided by health posts, 4.5 [95%CI: 3.867-5.116]. From the seven emergency newborn care signal functions, primary hospitals had a higher mean score, 6.3 [95%CI: 6.007-7.325] and rural health centres had a lowest mean score, 2.3 [95%CI: 2.043-2.623]. The availability of essential equipment is also significantly associated with the quality of neonatal care provision in the health facilities (p < 0.05). Overall, the effectiveness of the neonatal healthcare services has a significant association with the health facilitates readiness score [95%CI: 0.134-0.768]. Conclusion: The quality of newborn care was high at the higher-level health facilities and lower in the lower level health facilities such as rural health centres and health posts; where these facilities are designed to provide the newborn care services to the majority of the rural communities. In addition, the provision of emergency newborn care signal functions were critically low in rural health centres where these are a referral receiving health facilities from health posts. Thus, the rural health centres and health posts should be targeted to improve their readiness to provide the quality of services for newborns as per their expected level of care.

scholarly journals Emergency obstetric care provision in Southern Ethiopia: a facility-based survey

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018459 ◽  
Author(s):  
Mitchell Windsma ◽  
Tienke Vermeiden ◽  
Floris Braat ◽  
Andualem Mengistu Tsegaye ◽  
Asheber Gaym ◽  
...  
Keyword(s):  
Risk Factors ◽  
Assessment Tool ◽  
Health Workers ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
Southern Ethiopia ◽  
Signal Functions ◽  
Health Centres ◽  
Delivery Services ◽  
The Government

ObjectivesTo assess the provision of basic emergency obstetric and newborn care (BEmONC), knowledge of high-risk pregnancies and referral capacity at health centres in Southern Ethiopia.DesignA facility-based survey, using an abbreviated version of the Averting Maternal Death and Disability needs assessment tool for emergency obstetric and newborn care. Modules included infrastructure, staffing, number of deliveries, maternal and perinatal mortality, BEmONC signal functions, referral capacity and knowledge of risk factors in pregnancy.SettingPrimary healthcare centres providing delivery services in the Eastern Gurage Zone, a predominantly rural area in Southern Ethiopia.ParticipantsAll 20 health centres in the study area were selected for the assessment. One was excluded, as no delivery services had been provided in the 12 months prior to the study.ResultsThree out of 19 health centres met the government’s staffing norm. In the 12 months prior to the survey, 10 004 (X−=527±301) deliveries were attended to at the health centres, but none had provided all seven BEmONC signal functions in the three months prior to the survey (X−=3.7±1.2). Eight maternal and 32 perinatal deaths occurred. Most health centres had performed administration of parenteral uterotonics (17/89.5%), manual removal of placenta (17/89.5%) and neonatal resuscitation (17/89.5%), while few had performed assisted vaginal delivery (3/15.8%) or administration of parenteral anticonvulsants (1/5.3%). Reasons mentioned for non-performance were lack of patients with appropriate indications, lack of training and supply problems. Health workers mentioned on average 3.9±1.4 of 11 risk factors for adverse pregnancy outcomes. Five ambulances were available in the zone.ConclusionBEmONC provision is not guaranteed to women giving birth in health centres in Southern Ethiopia. Since the government aims to increase facility deliveries, investments in capacity at health centres are urgently needed.

scholarly journals Constructing a malaria-related health service readiness index and assessing its association with child malaria mortality: an analysis of the Burkina Faso 2014 SARA data

2020 ◽  
Author(s):  
Ourohiré Millogo ◽  
Jean Edouard Odilon Doamba ◽  
Ali Sié ◽  
Juerg Utzinger ◽  
penelope vounatsou
Keyword(s):  
Mortality Rate ◽  
Burkina Faso ◽  
Mortality Rates ◽  
Essential Medicines ◽  
Service Availability ◽  
Readiness Assessment ◽  
Malaria Mortality ◽  
Health Centres ◽  
Geostatistical Models ◽  
Facility Readiness

Abstract Abstract Background: The Service Availability and Readiness Assessment (SARA) surveys generate data on the readiness of health facility services. We constructed a readiness index related to malaria services and determined the association between health facility malaria readiness and malaria mortality in children under the age of 5 years in Burkina Faso. Methods: Data on inpatients visits and malaria-related deaths in under 5-year-old children were extracted from the national Health Management Information System (HMIS) in Burkina Faso. Bayesian geostatistical models with variable selection were fitted to malaria mortality data. The most important facility readiness indicators related to general and malaria-specific services were determined. Multiple correspondence analysis (MCA) was used to construct a composite facility readiness score based on multiple factorial axes. The analysis was carried out separately for 112 medical centres and 546 peripheral health centres. Results: Malaria mortality rate in medical centres was 4.8 times higher than that of peripheral health centres (3.46% vs. 0.72%, p<0.0001). Essential medicines was the domain with the lowest readiness (only 0.1% of medical centres and 0% of peripheral health centres had the whole set of tracer items of essential medicines). Basic equipment readiness was the highest. The composite readiness score explained 30% and 53% of the original set of items for medical centres and peripheral health centres, respectively. Mortality rate ratio (MRR) was by 59% (MRR = 0.41, 95% Bayesian credible interval (BCI): 0.19-0.91) lower in the high readiness group of peripheral health centres, compared to the low readiness group. Medical centres readiness was not related to malaria mortality. The geographical distribution of malaria mortality rate indicate that regions with health facilities with high readiness show lower mortality rates. Conclusion: Performant health services in Burkina Faso are associated with lower malaria mortality rates. Health system readiness should be strengthened in the regions of Sahel, Sud-Ouest and Boucle du Mouhoun. Emphasis should be given to improving the management of essential medicines and to reducing delays of emergency transportation between the different levels of the health system. Keywords: Bayesian geostatistical models, Burkina Faso, Composite readiness index, Malaria, Service Availability and Readiness Assessment

scholarly journals Assessing capacity of health facilities to provide routine maternal and newborn care in low-income settings: what proportions are ready to provide good-quality care, and what proportions of women receive it?

2019 ◽  
Author(s):  
Keith Tomlin ◽  
Della Berhanu ◽  
Meenakshi Gautham ◽  
Nasir Umar ◽  
Joanna Schellenberg ◽  
...  
Keyword(s):  
Low Income ◽  
Quality Care ◽  
Newborn Care ◽  
Uttar Pradesh ◽  
Routine Care ◽  
Health Facilities ◽  
Signal Functions ◽  
Maternal And Newborn Care ◽  
Maternal And Newborn

Abstract Background Good quality maternal and newborn care at primary health facilities is essential for both mothers and infants, but in settings with high maternal and newborn mortality the evidence for the protective effect of facility delivery is inconsistent. We surveyed samples of health facilities in three settings with high maternal mortality, to assess the quality of routine maternal and newborn care and the proportion of women delivering in facilities with a good standard of care. Surveys were conducted in 2012 and 2015 to assess changes in the quality of care over time. Methods Surveys were conducted in Ethiopia, the Indian state of Uttar Pradesh and Gombe State in North-Eastern Nigeria. 166 and 305 primary care facilities were sampled in 2012 and 2015 respectively. In each year we assessed whether each facility could provide four “signal” functions of routine maternal and newborn care. From facility registers we counted the number of deliveries in the previous six months and calculated the proportion of women giving birth in facilities which could offer good quality routine care. Results In Ethiopia the proportion of deliveries in facilities which provided all four signal functions rose from 40% (95% CI 26-57) in 2012 to 43% (95% CI 31-56) in 2015. In Uttar Pradesh in 2012 an estimated 4% (95% CI 1-24) of facility deliveries occurred in facilities which provided all four signal functions, rising to 39% (95% CI 25-55) in 2015. In Nigeria these estimates were 25% (95% CI 6-66) and zero for 2012 and 2015 respectively. Improvements in signal functions in Ethiopia and Uttar Pradesh were led by improved supplies of commodities while Nigeria experienced declines in supplies of commodities and the number of Skilled Birth Attendants employed. Conclusions This study quantifies how health facilities can provide sub-optimal maternal and newborn care, and may help explain inconsistent outcomes of health facility care in some settings. Signal function methodology can provide a rapid and inexpensive measure of the capacity of facilities to provide such care. Incorporating data on facility deliveries and repeating the analyses highlights the adjustments that could have greatest impact upon maternal and newborn care.

scholarly journals Assessment of Availability and Quality of Emergency Obstetric and Newborn Care Service in Southwestern Oromia, Ethiopia, 2017

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dejene Edosa
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Care Service ◽  
Newborn Care ◽  
Neonatal Morbidity ◽  
Categorical Variables ◽  
Care Providers ◽  
Cross Sectional ◽  
Signal Functions

Background. Emergency obstetrics and newborn care (EmONC) is an important lifesaving function which can avert the death of women facing obstetrics-related complications. It is a cost-effective, significant intervention to decrease maternal and neonatal morbidity and mortality in poor resource settings, including Ethiopia. Objective. The aim of this study was to assess the availability and quality of the EmONC services in southwestern Oromia, Ethiopia, in 2017. Methods. An institutional-based cross-sectional study was implemented from April to May 2017. Data were collected using checklists and questionnaires developed from different studies. Data were analyzed using EPI-info and exported to SPSS version 20 for further analysis. Each descriptive statistic was summarized using frequency, percentage, and tables for categorical variables. Results. Despite the fact that the overall coverage of fully functioning basic emergency obstetric and newborn care (BEmONC) facilities was greater than 5 per 500,000 people, nearly one-fourth (25.64%) provided less than expected signal functions, indicating that these facilities were nonfunctional. There were only 0.24 comprehensive emergency obstetric and newborn care (CEmONC) facilities per 500,000 people. The result of this study also revealed that the quality of EmONC facilities in all health-care settings was poor. Conclusion and Recommendation. There were gaps in performance signal functions as well as the availability and quality of EmONC in the study area. Availability and quality of EmONC necessitate improvements through enhancing health-care providers’ skills by training and mentoring as well as enabling facilities accessible for utilization of EmONC. Further research is needed to identify factors that could be barriers to the performance quality and coverage of EmONC services.

Health Infrastructure and Economic Development in India

2018 ◽  
pp. 78-97
Author(s):  
Dibyendu Ghosh ◽  
Soumyananda Dinda
Keyword(s):  
Health Care ◽  
Economic Development ◽  
Life Expectancy ◽  
Access To Health Care ◽  
Care Service ◽  
Health Care Service ◽  
Uttar Pradesh ◽  
Health Facilities ◽  
Care Services ◽  
Health Infrastructure

The chapter examines different aspects of health care service facilities and health infrastructure available in India. Major health outcomes like Life expectancy at birth and infant mortality rate depend on available health facilities like hospitals, beds and health trained personnel. Life expectancy in India has increased and IMR declines over the years, except few states like Bihar, Jharkhand, Madhya Pradesh, Uttar Pradesh. India has achieved a considerable progress in providing health infrastructure and its access to health care services to the mass population. However, less developed states like Uttar Pradesh and Bihar need more attention to improve health infrastructure and distribution of health facilities. In this context, we also highlight the department of Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy, abbreviated as AYUSH which is a Governmental body in India purposed with developing, education and research in Ayurveda, which mostly prevails in under-developed state like Bihar. Our empirical results provide the evidence of strong association between health infrastructure and economic development in India.

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.

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