Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

Abstract

Background Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Even though Ethiopia has endorsed the implementation of ENC, as other many counties, it has been challenged. This study was conducted to measure the level of essential newborn care practice and identify health facility level attributes for consistent delivery of ENC services by health care providers. Methods This study employed a retrospective cross-sectional study design in 425 facilities. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p < 0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors—availability of essential obstetrics drugs in delivery rooms, high community score card (CSC) performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of consistent delivery of essential newborn care (CD-ENC) was consistent partograph use, recording an odds ratio of 2.66 (AOR = 2.66, 95%CI: 1.71, 4.13). Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 (AOR = 1.88, 95%CI: 1.15, 3.08) times higher odds of exhibiting consistent delivery of ENC. Conclusion The delivery of essential newborn care depends on both health provider and facility manager actions and availability of platforms to streamline relationships between the clients and health facility management.

Barriers and facilitators in implementing early essential newborn care of well‐born babies in low‐ and middle‐income countries: A mixed‐method systematic review

“…2021b; Fekadu et al. 2022) confirmed that drawing a partogram (a graph of labour progress and the maternal and foetal condition) could inform implementors the required steps. In contrast, three studies indicated that the lack of concrete and feasible operating procedures was a challenge (Gonfa et al.…”

“…2021b; Fekadu et al. 2022; Mwakawanga & Mselle, 2020; Nahidi, & T. S. Haidarzade M, Hajizadeh E. 2014), could improve newborn care.…”

“…One study showed that community scorecard performance and women‐friendly delivery services (Fekadu et al. 2022) could significantly contribute to EENC implementation. Another study stated that private hospitals listed EENC as a special service (Morseth et al.…”

“…2021b; Fekadu et al. 2022) and positive staff involvement (Mbalinda et al. 2018) could promote EENC implementation.…”

“…Four studies reported that a lack of teamwork(Alenchery et al 2018;Rana et al 2019;Vail et al 2018) and a delegation system for tasks(Delele et al 2021a) were challenging. The cooperation was often between the paediatrician, gynaecologist and labour room workers(Alenchery et al 2018) and the role of nurses was stressed(Holztrattner et al 2021).The construct of structural characteristics, which referred to the structure, age, level and size of an organisation, was reported by five studies(Berhe et al 2017;Birhanu & Mathibe-Neke, 2022;Fekadu et al 2022;Morseth et al 2020;Vail et al 2018).as a special service(Morseth et al 2020).The construct of implementation climate, which referred to the absorptive capacity for change in an organisation, was identified by five studies. Three studies found that friendly service(Delele et al 2021b;Fekadu et al 2022) and positive staff involvement (Mbalinda et al 2018) could promote EENC implementation.…”