Readiness of Primary Hospitals in Providing Neonatal Intensive Care Services in Ethiopia

Abstract

BACKGROUND፡ The Ethiopian neonatal mortality has not shown much progress over the years. In light of this, the country has introduced interventions such as the utilization of newborn corners and neonatal intensive care units to avert preventable neonatal deaths. This study was conducted to assess readiness of primary hospitals in providing neonatal intensive care services.METHODS: A health facility based cross-sectional study design was employed where data were collected using both prospective and retrospective techniques using a format adapted from national documents. SPSS version 25 was used for data entry and analysis using descriptive statistics.RESULTS: Data were collected from 107 of 113 (94.7%) primary hospitals due to inaccessibility of some primary hospitals. The minimum national standard requirement of a level one neonatal intensive care unit for infrastructure was met by 63% (68/107) and 44% (47/107) had fulfilled the requirements for kangaroo mother care units. The average number of neonatal intensive care unit trained nurses per primary hospital was 2.6, 0.8 for general practitioners and 2.9 support staff; all of which is less than the minimum recommended national standard. The minimum national requirement for medical equipment and renewables for primary hospital level was fulfilled by 24% (26/107) of the hospitals, 65% (70/107) for essential laboratory tests, and 87% (93/107) for clinical services and procedures. The average number of admissions during the six months prior to the data collection was 87.2 sick newborns per facility with a ‘discharged improved’ rate of 71.5%, referral out rate of 18.4% and level one neonatal intensive care unit death rate of 6.6%. The remaining newborns had either left against medical advice or were still undergoing treatment during data collection.CONCLUSIONS: The overall readiness of primary hospitals to deliver neonatal intensive care services in terms of infrastructure, human resource, medical equipment, and laboratory tests was found to be low. There is a need to fill gaps in infrastructure, medical equipment, renewables, human resource, laboratory reagents, drugs and other supplies of neonatal intensive care units of primary hospitals to garner better quality of service delivery.

Quality of care provided to sick children in health facilities in Ethiopia: a systematic review

“…Likewise, the level of care at the health post, health center or hospital level was substandard. The overall structural standards for a NICU were met by 63% of the studied primary hospitals (32), and 65.2% of the required equipment, and 72.2% of medicines, were met in the NICU ward of a referral hospital (51). Similarly, Biadgo, et al (19) reported that only 15.6% of the studied health facilities ful lled the standards for quality childcare provision.…”

“…In addition, seven (26.9%) studies assessed health outcomes at both individual and population levels. Five of the studies (71.4%) looked at the effectiveness of interventions in reducing childhood mortality at a population level(32,41,45, 62, 63), while four (57.1%) examined clinical or treatment outcomes, including recovery and complication rates and adverse effects of clinical treatment(32, 37,…”

Cultural, Institutional and Policy Impact on Neonatal Safety Practice in Ethiopia: A Concept from Policy Dialogue

“…The average number of neonatal intensive care unit-trained nurses per primary hospital was below the recommended national standard. The survey also found that the minimum national requirement for medical equipment and renewables for neonate care was met only by 24% hospitals, 65% for essential laboratory tests, and 87% for clinical services and procedures [13].…”

Magnitude of institutional neonatal morality rates in neonatal intensive care units of developing regions of Ethiopia: a retrospective review.

“…The minimum national requirement for medical equipment and renewables was ful lled by 24% of hospitals, 65% for essential laboratory tests, and 87% for clinical services and procedures. (10).…”