Evidence‐based training and mentorship combined with enhanced outcomes surveillance to address the leading causes of neonatal mortality at the district hospital level in Ghana

Abstract

Abstractobjective To evaluate the impact of a district hospital intervention focused on enhancing healthcare provider capacity to address leading causes of neonatal death: birth asphyxia, infection and prematurity.methods The neonatal quality improvement initiative was launched at two intervention referral district hospitals in Ghana. Local Health and Demographic Surveillance Systems were enlisted to enhance recording of neonatal and infant deaths in the community and at the facility. After baseline site assessments, a team of local paediatric experts conducted three clinical trainings on-site at each intervention hospital. Assessments were conducted to evaluate participant knowledge before and after participation in training modules. Monthly mentorship visits provided additional training to support the adoption of essential early neonatal care practices.results In the first year of implementation, the initiative provided focused clinical training to 278 participants. A comparison of pre-and post-training test results demonstrates significant improvement in provider knowledge (73% vs. 89% correct, P < 0.001), with even greater improvement among trainees receiving recurrent refresher training (86% vs. 94% correct, P < 0.001). Participant feedback following training revealed enthusiasm about the programme and improved confidence.conclusions Locally led initiatives that invest directly in healthcare provider education and health systems strengthening represent a promising avenue for reducing neonatal morbidity and mortality. The NQI initiative demonstrates the positive impact of a district hospital intervention that combines on-site training, mentorship and enhanced demographic surveillance.keywords neonatal mortality, training, mentorship, evidence-based, district hospitals, Ghana

Inpatient care of small and sick newborns: a multi-country analysis of health system bottlenecks and potential solutions

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“…In addition to task shifting there are other immediate, interim strategies that can be put in place. These could include improving conditions for the workforce through incentives [ 38 ] (financial, educational or other), relieving staff of other duties, improving daily working conditions (break areas, food vouchers, accommodation on-site or nearby) [ 39 ] and improving job satisfaction through structured supervision and mentoring efforts [ 32 ]. Non-rotation of staff out of neonatal care is an important strategy to prevent neonatal staff being shifted annually within the hospital from department to department or into other specialties (Figure 6 ).…”

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“…In addition, a community outreach component to educate women on the importance of sharing pregnancy status with healthcare providers will likely be needed to facilitate the patient/ provider interaction. Multiple coordinated approaches and overall capacity building will be important keys to the improvement of MiP case management practice across facilities and has been shown to be effective in the region [ 37 , 38 ].…”

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