Assessment of content validity for a Neonatal Near miss Scale in the context of Ethiopia

Asaye, Mengstu Melkamu; Gelaye, Kassahun Alemu; Matebe, Yohannes Hailu; Lindgren, Helena; Erlandsson, Kerstin

doi:10.1080/16549716.2021.1983121

Cited by 7 publications

(14 citation statements)

References 33 publications

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“…Neonatal Near Miss (NNM) refers to neonates with severe complications who almost died but survived immediately after birth. In Ethiopia, the prevalence of NNM has been assessed using a validated Neonatal Near-Miss Assessment Scale [ 1 – 3 ]. In the validated Neonatal Near-Miss Assessment Scale [ 1 – 3 ] NNM is defined as neonates who nearly died but survived after birth in hospitals’ labor wards or neonatal intensive care units, meeting at least one criterion of the validated Neonatal Near-Miss Assessment Scale.…”

Section: Introductionmentioning

confidence: 99%

“…In Ethiopia, the prevalence of NNM has been assessed using a validated Neonatal Near-Miss Assessment Scale [ 1 – 3 ]. In the validated Neonatal Near-Miss Assessment Scale [ 1 – 3 ] NNM is defined as neonates who nearly died but survived after birth in hospitals’ labor wards or neonatal intensive care units, meeting at least one criterion of the validated Neonatal Near-Miss Assessment Scale. There are certain medical criteria playing a significant role in Ethiopia [ 1 – 3 ] whereas determinants related to caring also have a causal or influential role in the survival of neonatal near-miss babies in clinical management and care, and these aspects have not been explored or studied yet in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

“…In the validated Neonatal Near-Miss Assessment Scale [ 1 – 3 ] NNM is defined as neonates who nearly died but survived after birth in hospitals’ labor wards or neonatal intensive care units, meeting at least one criterion of the validated Neonatal Near-Miss Assessment Scale. There are certain medical criteria playing a significant role in Ethiopia [ 1 – 3 ] whereas determinants related to caring also have a causal or influential role in the survival of neonatal near-miss babies in clinical management and care, and these aspects have not been explored or studied yet in Ethiopia. In the validated NNM Assessment Scale [ 1 – 3 ] the medical criteria include pregnancy-induced hypertension, premature rupture of membranes, referral from other health facilities, fetal malposition and prolonged active first stage of labor.…”

Section: Introductionmentioning

confidence: 99%

“…There are certain medical criteria playing a significant role in Ethiopia [ 1 – 3 ] whereas determinants related to caring also have a causal or influential role in the survival of neonatal near-miss babies in clinical management and care, and these aspects have not been explored or studied yet in Ethiopia. In the validated NNM Assessment Scale [ 1 – 3 ] the medical criteria include pregnancy-induced hypertension, premature rupture of membranes, referral from other health facilities, fetal malposition and prolonged active first stage of labor. To meet the 2030 Sustainable Development Goal (SDG) [ 4 ] Ethiopia plans to reduce neonatal mortality from 29 to 12 per 1000 live births by implementing proven and cost-effective newborn survival interventions [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Our research group has used the validated Neonatal Near-Miss Assessment Scale [ 1 , 2 ] as an audit and feedback system in University of Gondar, Debretabor, and Felegehiwot comprehensive specialized hospitals, as well as Debark General Hospital in the Amhara Regional State of northwest Ethiopia [ 1 – 3 ]. The relationship between fetal malposition, primiparous births, referrals from other health facilities, premature rupture of membranes, and NNM was partially mediated by grade III meconium-stained amniotic fluid and the duration of the active first stage of labor.…”

Section: Introductionmentioning

confidence: 99%

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Experience and perceptions of healthcare providers on clinical management and care of near-miss infants: a qualitative content analysis

Asaye,

Gelaye,

Matebe

et al. 2023

BMC Health Serv Res

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Introduction Neonatal Near Miss (NNM) refers to neonates with severe complications who almost died but survived immediately after birth. In Ethiopia, the prevalence of NNM has been assessed using a validated Neonatal Near-Miss Assessment Scale. However, understanding the experiences and perceptions of healthcare providers in the clinical management and care of NNM infants remains unexplored. The aim was to investigate the determinants contributing to the survival of neonatal near-miss babies and to identify any barriers encountered, as reported by the experiences of healthcare providers in public hospitals of Amhara Regional State, northwest Ethiopia. Methods Semi structured interviews were used to collect data from 25 midwives, nurses, and pediatricians with at least six months of prior experience in one of the labor wards or neonatal intensive care units at one of the four public health hospitals in the Amhara Regional state of northwest Ethiopia included in a large intervention study assessing a NNM scale. Purposeful sampling was used, selecting participants based on their experiences related to the aim of this study. The participants had a varying level of education and years of experience to care for NNM infants. The average age of the healthcare providers was 31 years, with 7 years of work experience. The transcripts of the interviews with the healthcare providers were analyzed using qualitative content analysis. Results The experience and perceptions of healthcare providers was described in the main category “A sense of hopelessness when caring for the baby” capturing a broader emotional and professional aspect, while the subcategories “Unclear responsibilities discharging one’s mission”, “Provision of kangaroo mother care” and “Quick action required at birth” are more specific and practical. Healthcare providers perceived a sense of hopelessness when caring for the NNM infant, particularly providing Kangaroo Mother Care (KMC) and quick actions when required at birth to save the life of the infant. Conclusion Unclear responsibilities and a sense of hopelessness could have acted as barriers, hindering the ability of healthcare providers to fulfill their mission of taking swift actions and providing KMC to NNM infants, thus impacting their ability to save the lives of these infants. Healthcare providers’ and parents’ attitudes must be changed towards hope rather than hopelessness when caring for NNM infants.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Experience and perceptions of healthcare providers on clinical management and care of near-miss infants: a qualitative content analysis

Asaye,

Gelaye,

Matebe

et al. 2023

BMC Health Serv Res

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Valid and reliable neonatal near-miss assessment scale in Ethiopia: a psychometric validation

Asaye

Alemu

Matebe

et al. 2022

Global Health Action

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Background The concept of a neonatal near miss is used to explain neonates who nearly died but survived a life-threatening complication in the first 28 days of life. We have left many ill surviving (near-miss) neonates, due to a lack of valid and reliable assessment scale, particularly in Ethiopia. Aim We aim to psychometrically validate the neonatal near-miss assessment scale (NNMAS) for Ethiopia. Methods A total of 465 live birth neonates were included with the assumption of a participant-to-item ratio of 15:1. A new contextually validated NNMAS was used to collect data. The Kaiseri––Mayer––Olkin (KMO) measure of sampling adequacy with a cutoff value of ≥0.50 for each item was applied. For reliability and validity of NNMAS, exploratory factor analysis using principal component analysis with oblique varimax rotation was used. Internal consistency and reliability were assessed using Cronbach’s alpha. Convergent and discriminant validity was assessed using composite reliability (CR) and average variance extracted (AVE). Results The Kaiser––Mayer––Olkin (KMO = 0.74) measure of sampling adequacy and Bartlett’s Sphericity test for the appropriateness of the identity matrix ( χ 2 = 2903.9, df = 276, and P = 0.000) were suitable for exploratory factor analysis (EFA). The correlation matrix determinant of the study was 0.002. The principal component analysis (PCA) identified six factors and together explained 54.3% of the variation in the Neonatal Near miss. The Cronbach-alpha coefficient was 0.80 for the entire scale. The composite reliability values of the factors ranged from 0.87 to 0.95. The AVEs, CR, and factor loadings were above 0.5 for all factors indicating that convergent validity was met. The square roots of the AVEs were greater than factor correlation values. It was revealed that discriminated validity was also met. Conclusion The neonatal near-miss assessment scale was found to be valid and reliable in the present context. The scale can be used to identify near-miss neonates in Ethiopia.

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Effect of fetal malposition, primiparous, and premature rupture of membrane on Neonatal Near miss mediated by grade three meconium-stained amniotic fluids and duration of the active first stage of labor: Mediation analysis

et al. 2023

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Background In many low-income countries, including Ethiopia, neonatal mortality remains a major concern. For every newborn that dies, many more neonates survived (near-miss neonates) the first 28 days after birth from life-threatening conditions. The generation of evidence on neonatal near-miss determinants could be a critical step in reducing neonatal mortality rates. However, studies causal pathway determinants are limited in Ethiopia. This study aimed to investigate the Neonatal Near-miss determinants in public health hospitals in Amhara Regional State, northwest Ethiopia. Method A cross-sectional study was conducted on 1277 mother-newborn pairs at six hospitals between July 2021 and January 2022. A validated interviewer-administered questionnaire and a review of medical records were used to collect data. Data were entered into Epi-Info version 7.1.2 and exported to STATA version 16 in California, America for analysis. The paths from exposure variables to Neonatal Near-Miss via mediators were examined using multiple logistic regression analysis. The adjusted odds ratio (AOR) and ß-coefficients were calculated and reported with a 95% confidence interval and a p-value of 0.05. Results The proportion of neonatal near-misses was 28.6% (365/1277) (95% CI: 26–31%). Women who could not read and write (AOR = 1.67,95%CI:1.14–2.47), being primiparous (AOR = 2.48,95% CI:1.63–3.79), pregnancy-induced hypertension (AOR = 2.10,95% CI:1.49–2.95),being referred from other health facilities (AOR = 2.28,95% CI:1.88–3.29), premature rupture of membrane (AOR = 1.47,95% CI:1.09–1.98), and fetal malposition (AOR = 1.89,95% CI:1.14–3.16) were associated with Neonatal Near-miss. Grade III meconium stained amniotic fluid partially mediated the relationship between primiparous (ß = 0.517), fetal malposition (ß = 0.526), pregnant women referred from other health facilities (ß = 0.948) and Neonatal Near-Miss at P-value < 0.01. Duration of the active first stage of labour partially mediated the relationship between primiparous (ß = -0.345), fetal malposition (ß = -0.656), premature rupture of membranes (ß = -0.550) and Neonatal Near-Miss at P- value <0.01.It had also a significant indirect effect (ß = 0.581, P<0.001) on NNM with variables (primiparous, fetal malposition, and premature rupture of membranes). Conclusions The relationship between fetal malposition, primiparous, referred from other health facilities, premature rupture of membrane, and Neonatal Near miss were partially mediated by grade III meconium stained amniotic fluid and duration of the active first stage of labour. Early diagnosis of these potential danger signs and appropriate intervention could be of supreme importance in reducing NNM.

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Assessment of content validity for a Neonatal Near miss Scale in the context of Ethiopia

Cited by 7 publications

References 33 publications

Experience and perceptions of healthcare providers on clinical management and care of near-miss infants: a qualitative content analysis

Experience and perceptions of healthcare providers on clinical management and care of near-miss infants: a qualitative content analysis

Valid and reliable neonatal near-miss assessment scale in Ethiopia: a psychometric validation

Effect of fetal malposition, primiparous, and premature rupture of membrane on Neonatal Near miss mediated by grade three meconium-stained amniotic fluids and duration of the active first stage of labor: Mediation analysis

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