Barriers to neonatal care in developing countries: Parents' and providers' perceptions

Martinez, Alma M; Khu, Dung Thi Khanh; Ny, Boo; Neou, Leakhena; Saysanasongkham, Bounnack; Partridge, John Colin

doi:10.1111/j.1440-1754.2012.02544.x

Cited by 34 publications

(34 citation statements)

References 29 publications

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“…These factors had a negative impact on the performance of the healthcare system and health outcomes. This agrees with a study in 4 hospitals in Southeast Asia where cost of neonatal care, hospital infrastructure and access to medication are important barriers to neonatal care in developing countries (25).…”

Section: Discussionsupporting

confidence: 79%

Medical errors in neonatal intensive care unit at Benha University Hospital, Egypt

El-Shazly¹,

Al-Azzouny²,

Soliman³

et al. 2017

East Mediterr Health J

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This study was conducted in the neonatal intensive care unit of Benha University Hospital, Egypt from 1 August 2012 to the 31 January 2013 to identify medical errors and to determine the risk factors and consequences of these errors. Errors were detected by follow-up of neonates and review of reports including nursing followup sheets, resident progression notes and investigation reports. We detected 3819 errors that affected 97% of neonates. Types of errors included 403 medication errors (10.55% of total errors), 652 errors in daily routine procedures (17.07%), 1042 errors in invasive procedures (27.28%), 68 errors in nutrition (1.78%), 63 equipment errors (1.64%), 260 administration errors (6.8%), 656 staffing errors (17.18%), 107 environmental errors (2.8%), 448 infection control errors (11.73%) and 120 nosocomial infection errors (3.14%). Medical errors were high in low birth weight, low gestational age neonates and increased with duration of admission. RÉSUMÉ La présente étude a été conduite dans l'unité néonatale de soins intensifs du centre hospitalier universitaire de Banha, en Égypte, du 1 er août 2012 au 31 janvier 2013, dans le but d'identifier les erreurs médicales et de déterminer les facteurs de risque et les conséquences associés. Des erreurs ont été détectées dans le suivi des nouveau-nés et l'analyse de rapports incluant des fiches de suivi des soins infirmiers, des notes sur la progression des internes, et des rapports d'enquête. Nous avons détecté 3 819 erreurs ayant affecté 97 % des nouveau-nés. Les types d'erreurs incluaient 403 erreurs de médication (10,55 % du nombre total d'erreurs), 652 erreurs dans les actes de routine journaliers (17,07 %), 1 042 erreurs dans les procédures invasives (27,28 %), 68 erreurs de nutrition (1,78 %), 63 erreurs d'équipement (1,64 %), 260 erreurs administratives (6,8 %), 656 erreurs au niveau du personnel (17,18 %), 107 erreurs en matière de pratiques environnementales (2,8 %), 448 erreurs liées à la lutte contre les infections (11,73 %) et 120 erreurs entraînant des infections nosocomiales (3,14 %). Les erreurs médicales étaient nombreuses dans les cas de nouveau-nés souffrant d'une insuffisance pondérale à la naissance ou étant nés prématurément, et elles augmentaient en fonction de la durée de l'hospitalisation. ‫مرص‬

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Section: Discussionsupporting

confidence: 79%

Medical errors in neonatal intensive care unit at Benha University Hospital, Egypt

El-Shazly¹,

Al-Azzouny²,

Soliman³

et al. 2017

East Mediterr Health J

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“…Distance and transport are reported as the major barriers to accessing maternal and paediatric health services in many developing countries 24 25. In addition to the cost of transport, a major financial barrier to treatment for both HIV and malnutrition is the cost of medical treatment in countries where public healthcare is not available; this can ostracise the poorest in the community.…”

Section: Aetiology Of Disease: Socialmentioning

confidence: 99%

Aetiology and management of malnutrition in HIV-positive children

Rose¹,

Hall

Martinez-Alier

2014

Archives of Disease in Childhood

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Worldwide, more than 3 million children are infected with HIV and, without treatment, mortality among these children is extremely high. Both acute and chronic malnutrition are major problems for HIV-positive children living in resource-limited settings. Malnutrition on a background of HIV represents a separate clinical entity, with unique medical and social aetiological factors. Children with HIV have a higher daily calorie requirement than HIV-negative peers and also a higher requirement for micronutrients; furthermore, coinfection and chronic diarrhoea due to HIV enteropathy play a major role in HIV-associated malnutrition. Contributory factors include late presentation to medical services, unavailability of antiretroviral therapy, other issues surrounding healthcare provision and food insecurity in HIV-positive households. Treatment protocols for malnutrition have been greatly improved, yet there remains a discrepancy in mortality between HIV-positive and HIV-negative children. In this review, the aetiology, prevention and treatment of malnutrition in HIV-positive children are examined, with particular focus on resource-limited settings where this problem is most prevalent.

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“…Martinez et al also conducted surveys with 212 health care providers, exploring their perceptions of barriers in providing care. The surveys undertaken with health care providers in Vietnam ( n = 63) highlighted a lack of nursing staff as a concern to providing more aggressive treatment on the neonatal unit [21]. While this was reported by nurses in our study, we also found that parents felt that there should be more staff to help mothers care for their infant.…”

Section: Discussionmentioning

confidence: 50%

“…Reports by the nurses that parents should help support them to care for the infants also suggests a need for more nursing support on the neonatal unit. Health care providers cited a lack of staff training as impacting the provision of neonatal care in the study by Martinez et al [21], which is emphasised by our own study in which the nurse highlight their sense of pride from their training through increased knowledge, impact upon practice and improved infant care. This suggests that implementing an educational intervention can build staff confidence, lead to an increased sense of professional identity, and help nursing staff to perform their role.…”

Section: Discussionmentioning

confidence: 89%

“…Very few studies have performed qualitative research in this area; however one study in particular carried out qualitative interviews with 198 parents of infants who were hospitalised within the first month of life in Cambodia, Malaysia, Laos and Vietnam, and explored perceived barriers to newborn care [21]. Results highlighted that parents had low levels of satisfaction with their neonatal experiences, with parents from one unit in Hanoi, Vietnam, specifically ( n = 48) citing issues such as availability of medications, privacy, cleanliness and staff demeanour as areas which negatively impacted their experience.…”

Section: Discussionmentioning

confidence: 99%

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Nursing & parental perceptions of neonatal care in Central Vietnam: a longitudinal qualitative study

et al. 2017

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BackgroundNeonatal mortality accounts for nearly three quarters of all infant deaths in Vietnam. The nursing team are the largest professional group working with newborns, however do not routinely receive neonatal training and there is a lack of research into the impact of educational provision. This study explored changes in nursing perceptions towards their role following a neonatal educational intervention. Parents perceptions of nursing care were explored to determine any changes as nurses gained more experience.MethodSemi-Structured qualitative interviews were conducted every 6 months over an 18 month period with 16 nurses. At each time point, parents whose infant was resident on the neonatal unit were invited to participate in an interview to explore their experiences of nursing care. A total of 67 parents participated over 18 months. Interviews were conducted and transcribed in Vietnamese before translation into English for manifest content analysis facilitated by NVivo V14.ResultsAnalysis of nursing transcripts identified 14 basic categories which could be grouped (23) into 3 themes: (1) perceptions of the role of the neonatal nurse, (2) perception of the parental role and (3) professional recollections. Analysis of parent transcripts identified 14 basic categories which could be grouped into 3 themes: (1) information sharing, (2) participation in care, and (3) personal experience.ConclusionsQualitative interviews highlighted the short term effect that the introduction of an educational intervention can have on both nursing attitudes towards and parental experience of care in one neonatal unit in central Vietnam. Nurses shared a growing awareness of their role along with its ethical issues and challenges, whilst parents discussed their overall desire for more participation in their infants care. Further research is required to determine the long term impact of the intervention, the ability of nurses to translate knowledge into clinical practice through assessment of nursing knowledge and competence, and the impact and needs of parents. A greater understanding will allow us to continue to improve the experiences of nurses and parents, and highlight how these areas may contribute towards the reduction of infant mortality and morbidity in Vietnam.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0909-6) contains supplementary material, which is available to authorized users.

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Barriers to neonatal care in developing countries: Parents' and providers' perceptions

Cited by 34 publications

References 29 publications

Medical errors in neonatal intensive care unit at Benha University Hospital, Egypt

Medical errors in neonatal intensive care unit at Benha University Hospital, Egypt

Aetiology and management of malnutrition in HIV-positive children

Nursing & parental perceptions of neonatal care in Central Vietnam: a longitudinal qualitative study

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