A rapid assessment of the quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania

Mbwele, Bernard; Reddy, Elizabeth; Reyburn, Hugh

doi:10.1186/1471-2431-12-182

Cited by 26 publications

(44 citation statements)

References 26 publications

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“…The normograms recommended by the American Academy of Paediatrics were frequently used, with or without modification, to predict the risk and severity of hyperbilirubinaemia. However, objective and reliable evaluation of the severity of hyperbilirubinaemia based on plasma bilirubin estimation was frequently hampered by the lack of bilirubin measuring/monitoring devices and in‐house laboratory facilities . Clinical investigations for blood group incompatibilities and G6PD deficiency to determine the risk profile of infants were not routinely undertaken, even in some tertiary hospitals.…”

Section: Diagnosis Of Severe Hyperbilirubinaemiamentioning

confidence: 99%

Addressing the burden of neonatal hyperbilirubinaemia in countries with significant glucose‐6‐phosphate dehydrogenase deficiency

et al. 2014

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Section: Diagnosis Of Severe Hyperbilirubinaemiamentioning

confidence: 99%

Addressing the burden of neonatal hyperbilirubinaemia in countries with significant glucose‐6‐phosphate dehydrogenase deficiency

et al. 2014

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“…These finding are relatively similar to studies western Tanzania [31] but not in proportional differences. Half of the hospitals in Kilimanjaro region are church based and well equipped [37]. Kilimanjaro region has the potential to serve as a role model region for quality of neonatal care during the count down of MDG 4 for Tanzania.…”

Section: Discussionmentioning

confidence: 99%

“…It seems that mothers’ understanding towards responsibilities in postnatal care should be further studied to generate strategies [35] to improve neonatal care, such as those seen in west Africa at district level [36], which are lacking in Tanzania. There is evidence that there is poor record of care and lack of health workers motivation in northern Tanzania [37]. The affirmation of mothers’ opinions and suggestions in health care [38,39] can support a design for strategies to improve the quality of maternal and neonatal care, which will be key to helping Tanzania achieve the Millennium Development Goal Number 4 (MDG 4) of reducing child mortality [40-46].…”

Section: Introductionmentioning

confidence: 99%

Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences

et al. 2013

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BackgroundWith a decline of infant mortality rates, neonatal mortality rates are striking high in development countries particularly sub Saharan Africa. The toolkit for high quality neonatal services describes the principle of patient satisfaction, which we translate as mother’s involvement in neonatal care and so better outcomes. The aim of the study was to assess mothers’ experiences, perception and satisfaction of neonatal care in the hospitals of Kilimanjaro region of Tanzania.MethodsA cross sectional study using qualitative and quantitative approaches in 112 semi structured interviews from 14 health facilities. Open ended questions for detection of illness, care given to the baby and time spent by the health worker for care and treatment were studied. Probing of the responses was used to extract and describe findings by a mix of in-depth interview skills. Closed ended questions for the quantitative variables were used to quantify findings for statistical use. Narratives from open ended questions were coded by colours in excel sheet and themes were manually counted.Results80 mothers were interviewed from 13 peripheral facilities and 32 mothers were interviewed at a zonal referral hospital of Kilimanjaro region. 59 mothers (73.8%) in the peripheral hospitals of the region noted neonatal problems and they assisted for attaining diagnosis after a showing a concern for a request for further investigations. 11 mothers (13.8%) were able to identify the baby’s diagnosis directly without any assistance, followed by 7 mothers (8.7%) who were told by a relative, and 3 mothers (3.7%) who were told of the problem by the doctor that their babies needed medical attention. 24 times mothers in the peripheral hospitals reported bad language like “I don’t have time to listen to you every day and every time.” 77 mothers in the periphery (90.6%) were not satisfied with the amount of time spent by the doctors in seeing their babies.ConclusionMothers of the neonates play great roles in identifying the illness of the newborn. Mother’s awareness of what might be needed during neonatal support strategies to improve neonatal care in both health facilities and the communities.

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“…The Kilimanjaro region is generally characterized by poor performance of health workers in critical care for both peripheral and tertiary referral centres. While the tendency to refer neonates to tertiary centres is high, a majority of neonates die in the process of referral or immediately after a referral to a tertiary centre [29].…”

Section: Discussionmentioning

confidence: 99%

“…Qualitative approaches have rarely been made to synthesize and describe the causes of neonatal deaths in the hospitals during first referral care of the sick neonates. Little information can be obtained regarding the role of Health Care Workers, HCW in assuring the quality of neonatal health care in Tanzania [29]. The aim of this…”

Section: Introductionmentioning

confidence: 99%

Quality of Neonatal Health Care: Learning From Health Workers’ Experiences in Critical Care in Kilimanjaro Region, Northeast Tanzania

Ide¹

2013

Prim Health Care

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Background: Neonatal deaths are generally attributed to suboptimal standards of health care. Health care worker motivation and adherence to existing guidelines are rarely studied. The objective: To assess the performance of health workers for neonatal health care in the hospitals of Kilimanjaro region. Methods: A descriptive study using a semi-structured interview for health care workers at a tertiary referral hospital and peripheral health facilities (regional referral, district hospitals and health centres).was used. Health Care Workers (HCW) were asked to recall a scenario of a critically ill neonate admitted in the wards and the treatment that was provided. The WHO Emergency Triage Assessment and Treatment (ETAT) guidelines were used as a standard reference for knowledge of critical care. Results: Birth asphyxia was the most recalled health problem requiring critical care, reported by 27.5% of 120 HCW at both peripheral hospitals and by 46.4% of 28 health workers in tertiary referral centres. Half of the HCW commented on their own performance (47.5%, n=140). HCW presented with low to moderate levels of knowledge for critical care were at 92%. Supplementary training was associated with a higher levels of knowledge of neonatal critical care (p value = 0.05). HCW in peripheral hospital had lower levels of knowledge (only 44.7% at peripheral hospitals had sufficient ratings compared to 82.1% at the referral centre). [Pearson χ 2 (2) = 12.10, p value = 0.002]. Conclusion: Guided Practical-Competence Diagnostic Specific neonatal health care training is highly needed in the peripheral facilities of rural Kilimanjaro region. J o u rn al of P ri m a ry He alth ca re : O p en Acc e s s

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A rapid assessment of the quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania

Cited by 26 publications

References 26 publications

Addressing the burden of neonatal hyperbilirubinaemia in countries with significant glucose‐6‐phosphate dehydrogenase deficiency

Addressing the burden of neonatal hyperbilirubinaemia in countries with significant glucose‐6‐phosphate dehydrogenase deficiency

Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences

Quality of Neonatal Health Care: Learning From Health Workers’ Experiences in Critical Care in Kilimanjaro Region, Northeast Tanzania

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