Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

Abstract

ObjectiveTo present information on the quality of newborn care services and health facility readiness to provide newborn care in 6 African countries, and to advocate for the improvement of providers' essential newborn care knowledge and skills.DesignCross-sectional observational health facility assessment.SettingEthiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania.ParticipantsHealth workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed.Main outcome measuresIndicators of quality of newborn care included (1) provision of immediate essential newborn care: thermal care, hygienic cord care, and early and exclusive initiation of breast feeding; (2) actual and simulated resuscitation of asphyxiated newborn infants; and (3) knowledge of health workers on essential newborn care, including resuscitation.ResultsSterile or clean cord cutting instruments, suction devices, and tables or firm surfaces for resuscitation were commonly available. 80% of newborns were immediately dried after birth and received clean cord care in most of the studied facilities. In all countries assessed, major deficiencies exist for essential newborn care supplies and equipment, as well as for health worker knowledge and performance of key routine newborn care practices, particularly for immediate skin-to-skin contact and breastfeeding initiation. Of newborns who did not cry at birth, 89% either recovered on their own or through active steps taken by the provider through resuscitation with initial stimulation and/or ventilation. 11% of newborns died. Assessment of simulated resuscitation using a NeoNatalie anatomic model showed that less than a third of providers were able to demonstrate ventilation skills correctly.ConclusionsThe findings shared in this paper call attention to the critical need to improve health facility readiness to provide quality newborn care services and to ensure that service providers have the necessary equipment, supplies, knowledge and skills that are critical to save newborn lives.

Prevalence of Birth Asphyxia and Associated Factors among Neonates Delivered in Dilchora Referral Hospital, in Dire Dawa, Eastern Ethiopia

“…In our study 27 (11%) Neonates were died due to birth asphyxia after resuscitation which is similar with study done in six sub-Saharan Africa [59] but lower than study done in Tigray 31% [60] and in Jimma 23.2% [61] of Ethiopia and in Tanzania dar es salaam 62.5% [33] And in Nagaur, India (39%) [62] and 26% in Iran [57]. But higher than study done in IRAN (3.1%) [63].…”

Assessment of knowledge of evidence‐based maternal and newborn care practices among midwives and nurses in six provinces in Indonesia

“…The health worker interview tool was adapted from the quality of care survey tools developed by the Maternal and Child Integrated Program (MCHIP), which were developed and used in several countries, including Ethiopia, Kenya, Madagascar, and Tanzania . The interview tool was modified for the Indonesian context.…”

“…,whichweredevelopedandusedinseveralcountries,includ-ingEthiopia,Kenya,Madagascar,andTanzania 16. Theinterviewtool was modified for the Indonesian context.…”

Knowledge of Essential Newborn Care and Associated Factors among Nurses and Midwives: A Cross-Sectional Study at Public Health Facilities in Wolaita Zone, Southern Ethiopia, 2019

“…Overall average knowledge score on essential newborn care in India was 78% [10]. In Africa, 79% care providers dried baby with towel, 94% care providers cut cord with clean blade, 43% care providers initiated breastfeeding within the first one hour, 45% care providers placed new born skin to skin contact, and 65% clamped cord when pulsation stop or 2-3 min after birth [11]. Study conducted in Sudan Khartoum showing knowledge of the immediate care of the newborn showed that knowledge level was medium, that is, 50.6% [12].…”