Health system readiness to support facilities for care of preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

Usman, Abubeker Kedir; Wolka, Eskinder; Tadesse, Yared; Tariku, Abraham; Yeshidinber, Abate; Teklu, Alula M.; Senturia, Kirsten; Gezahegn, Wendemaghen; Litch, James A.

doi:10.1186/s12913-019-4672-2

Cited by 36 publications

(49 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although parental experience in the NICU was explored in different countries (2,5,(32)(33)(34), there are variations in, accessibility of health facilities, parent-HCPs and parental involvement in the care due to socio-cultural differences, nurses' working culture and the hospital setting (35)(36)(37)(38). And also, it is not well explored in Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

Parental Experiences in Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia: A Phenomenological Study

Mengesha

Zelellw

Asfaw

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Neonatal intensive care settings are important to save the lives of sick neonates; however, parents are challenged by many stressful conditions during their stay outside the rooms of intensive care units. Therefore, this study aimed to explore the lived experiences of parents in a neonatal intensive care unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Northwest Ethiopia. Methods: In this study, a phenomenological qualitative approach was used to explore parental experience and data were collected using in-depth interviews from purposively selected parents. In addition, a thematic approach was used to analyze the data using Open Code Software Version 4.02. Results: In this study, parents found to developed psychological problems like anxiety, stress, worry, hopelessness and state of confusion. Emotional related conditions were anger, crying, sadness, frustration, dissatisfaction, regret, disappointment, feeling bad, self-blaming, nervousness, disturbance and lack of self-control. Parents expressed that health care providers showed indiscipline, lack of commitment and not cooperative at all. Conclusion: Parents of neonates in the intensive care unit were challenged due to a shortage of money and traveling a long distance. Psychological and emotional factors were identified as major stressors of parents during their stay in the NICU. Hence, providing psycho-emotional supports, strengthening parents–healthcare providers’ interaction, and scale up neonatal intensive care unit service into the primary health care unit are recommended.

show abstract

Section: Introductionmentioning

confidence: 99%

Parental Experiences in Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia: A Phenomenological Study

Mengesha

Zelellw

Asfaw

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Lack of availability of, or access to, government-supported ambulance services for preterm, LBW, and sick newborns in both rural and urban settings points to the need for the FMOH to adequately finance and support a functional referral system as an important component of quality newborn care. Improving the referral system would also contribute to increasing the Ethiopian health system’s readiness to provide quality care to newborns [ 30 ]. This would directly support the Ministry’s national strategy for newborn and child survival for 2016–2020 target to reduce child morbidity and mortality through integrated child health care provisions and functional referral services [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: A responsive and well-functioning newborn referral system is a cornerstone to the continuum of child health care; however, health system and client-related barriers negatively impact the referral system. Due to the complexity and multifaceted nature of newborn referral processes, studies on newborn referral systems have been limited. The objective of this study was to assess the barriers for effective functioning of the referral system for preterm, low birth weight, and sick newborns across the primary health care units in 3 contrasting regions of Ethiopia. Methods: A qualitative assessment using interviews with mothers of preterm, low birth weight, and sick newborns, interviews with facility leaders, and focus group discussions with health care providers was conducted in selected health facilities. Data were coded using an iteratively developed codebook and synthesized using thematic content analysis. Results: Gaps and barriers in the newborn referral system were identified in 3 areas: transport and referral communication; availability of, and adherence to newborn referral protocols; and family reluctance or refusal of newborn referral. Specifically, the most commonly noted barriers in both urban and rural settings were lack of ambulance, uncoordinated referral and return referral communications between providers and between facilities, unavailability or non-adherence to newborn referral protocols, family fear of the unknown, expectation of infant death despite referral, and patient costs related to referral. Conclusions: As the Ethiopian Federal Ministry of Health focuses on averting early child deaths, government investments in newborn referral systems and standardizing referral and return referral communication are urgently needed. A complimentary approach is to lessen referral overload at higher-level facilities through improvements in the scope and quality of services at lower health system tiers to provide basic and advanced newborn care.

show abstract

“…Within NICUs, preterm newborns particularly are recipients of intensive care, together with term newborns affected by congenital malformation or birth asphyxia. According to the World Health Organisation (WHO), preterm birth is a worldwide challenge: 11.1% babies annually are born preterm worldwide (about 15 million babies); prematurity is the first cause of death for neonates; many preterm babies who survive face a lifetime of disability; and countries with health systems with low human and financial resources have higher mortality rates [ 5 – 7 ]. As for costs, Zupancic has estimated costs ranging from $76,000 to $159,000 per preterm baby in NICU [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Managerial features and outcome in neonatal intensive care units: results from a cluster analysis

Fanelli

Bellù

Zangrandi

et al. 2020

BMC Health Serv Res

View full text Add to dashboard Cite

Background Healthcare organisations differ in performance even if they are located in the same country or region. Suitable managerial practices and organisational processes can lead to better health outcomes. As a result, hospitals are constantly looking for managerial arrangements that can improve outcomes and keep costs down. This study aims to identify different managerial models in neonatal intensive care units (NICUs) and their impact on a large number of outcomes. Methods The research was conducted in Italy, within the SONAR project. SONAR’s aim was to identify the characteristics of NICUs, monitor outcomes and promote best practices. This study includes 51 of the 63 NICUs that took part in the SONAR project. Questionnaires on the activities and managerial features were administered to doctors and nurses working in NICUs. A total of 643 questionnaires were analysed from doctors and a total of 1601 from nurses. A cluster analysis was performed to identify managerial models of NICUs. Results Three managerial models emerged from cluster analysis: traditional, collaborative and individualistic. In the “traditional” model the doctor is above the nurse in the hierarchy, and the nurse therefore has exclusively operational autonomy. The “collaborative” model has as key elements professional specialisation and functional coordination. The “individualistic” model considers only individual professional skills and does not concern the organisational conditions necessary to generate organisational effectiveness. The results also showed that there is an association between managerial model and neonatal outcomes. The collaborative model shows best results in almost all outcomes considered, and the traditional model has the worst. The individualistic model is in the middle, although its values are very close to those of traditional model. Conclusions Health management needs to assess NICU strategically in order to develop models to improve outcomes. This study provides insights for management useful for designing managerial characteristics of NICUs in order to achieve better results. NICUs characterised by a collaborative model in fact show better neonatal outcomes.

show abstract

Health system readiness to support facilities for care of preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

Cited by 36 publications

References 18 publications

Parental Experiences in Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia: A Phenomenological Study

Parental Experiences in Neonatal Intensive Care Unit at Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Ethiopia: A Phenomenological Study

Referral systems for preterm, low birth weight, and sick newborns in Ethiopia: a qualitative assessment

Managerial features and outcome in neonatal intensive care units: results from a cluster analysis

Contact Info

Product

Resources

About