Health staff experiences with the implementation of early essential newborn care guidelines in Da Nang municipality and Quang Nam province in Viet Nam

Abstract

Background: The World Health Organization (WHO) recommends early essential newborn care (EENC)-The First Embraceas a simple lifesaving procedure for newborns. The successful implementation of EENC at scale requires an understanding of health staff experiences, including facilitators, barriers, and local adaptations of EENC. This study aims to gain insight into health staff experiences with implementation of EENC guidelines after participation in training and coaching initiatives in Da Nang municipality and Quang Nam province in Viet Nam. Methods: In each province/municipality, we randomly selected one hospital from the following categories: public provincial/municipal hospital, public district hospital, and private hospital. We conducted in-depth interviews with 19 hospital staff (11 midwives, 5 doctors and 3 health managers) and two trainers during 7 days between September and October 2017. We used deductive/inductive thematic analysis to generate themes. Results: The health staff reported improved staff and mother satisfaction, and health benefits for both mothers and newborns after implementing EENC. Facilitators to successful implementation were management support for resource allocation and collaboration across departments, and creative demand generation. Barriers included staff shortage, skepticism about the new protocols and practices and challenges translating knowledge and skills from trainings and coaching into practice. Conclusions: After implementing EENC, through training and coaching using the WHO approach, health staff reported improved staff and mother satisfaction as well as health benefits for both mothers and newborns. An approach to develop competencies, with a focus on practical training and coaching, should be promoted to form, reinforce and sustain recommended EENC practices among health staff.

Implementation of the Code of Marketing of Breast-Milk Substitutes in Vietnam: Marketing Practices by the Industry and Perceptions of Caregivers and Health Workers

“…The fact that almost 90% of the women brought BMS to the maternity facility at the time of childbirth or purchased it at or near by the facility suggests insufficient self-efficacy and unsupportive social norms related to the sufficiency of breastmilk in the first days of an infant’s life. The findings suggest the need for improving breastfeeding counseling for mothers and other family members during antenatal care, at the time of birth, and in the early days after birth, and for supporting breastfeeding through the provision of immediate and prolonged skin-to-skin contact, non-separation of the mother-baby dyad, and by reducing unnecessary cesarean sections [ 34 , 35 , 55 , 56 , 57 ].…”

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

“…Of the 12 qualitative studies, only two (Majra & Silan, 2016;Rana et al 2019) did not provide sufficient data to substantiate the interpreted results. One study had data collection method limitations because the sampling was convenient and the sample size was too small for the results to be generalised (Morseth et al 2020). Of the 13 quantitative studies, three (Abdu et al 2019;Berhe et al 2017;Tasew et al 2019) did not report selection criteria clearly and three (Abdu et al 2019;Ayenew et al 2020;Chanie et al 2021) did not consider confounders or apply appropriate methods to control for confounders.…”

Effectiveness of early essential newborn care implementation in four counties of western China

“…As WHO indicates, high-quality health care can encourage mothers to adopt pro-health behaviours [ 31 ]. Further, in Viet Nam, some private hospitals regarded EENC as a special service that attracted pregnant women seeking high-quality antenatal and childbirth care [ 18 ]. To optimize the experience of postpartum mothers and improve the quality of health services, efforts should be taken to make SSC available to all mothers and neonates.…”

“…Moreover, Frederick AC et al revealed that health staff shortages were also perceived as a challenge to the implementation of EENC practices in our pilot hospitals, leading to interruptions in health worker support for sustained SSC. [ 18 , 40 ] Since regional disparities between western rural counties and urban areas in economically developed provinces in China remain high, the allocations in equipment supplied to western health facilities should be increased (e.g., maternity wards, radiant warmers, and neonatal resuscitation equipment) [ 41 , 42 ]. In our present study, most postpartum mothers had junior high school or lower education.…”

“…Evidence has indicated that EENC-recommended interventions are practical and cost-effective for improving neonatal health outcomes in western China [ 12 , 13 ]. However, previous studies on EENC implementation were restricted to pre- and post-intervention design within groups [ 13 , 14 ]; used only cross-sectional observational investigation of service capacity [ 15 ]; employed a narrow research scope with small sample size [ 16 , 17 ]; and conducted limited qualitative research that lacked the perspectives of multiple stakeholders [ 18 , 19 ]. Moreover, most studies lacked controls and a multi-centre design [ 13 , 14 , 16 ].…”