Interventions to enhance newborn care in north-West Ethiopia: the experiences of health care professionals

Abstract

Background The provision of optimal and quality services during labour, delivery and in the early neonatal period is highly required to accelerate the reduction of neonatal deaths and improve the quality of life of newborns. The availability of competent health professionals and the essential medicines and supplies in the health facilities are compulsory. Cost-effective interventions exist to prevent more than 80% of all newborn deaths. However, an unacceptably high number of newborns are dying in the study area, and much is not known about the main contributing factors in primary healthcare settings. This study aimed to explore and describe the quality of care provided to newborns in the primary healthcare units. Methods Qualitative exploratory and descriptive design was employed. Focus group discussions were held with 26 participants (11 health workers and 15 health extension workers) in three woredas in the West Gojjam zone, Ethiopia. Health workers and health extension workers were purposely selected. Thematic analysis was undertaken. Results The primary healthcare facilities play a major role in the provision of essential services for newborns in the critical periods, including during labor and birth, immediately after birth and in the early postnatal care period. Resuscitation of birth asphyxia, prevention of hypothermia, initiation of breastfeeding, application of tetracycline, vitamin k injection, weighing babies and chlorhexidine application were identified as immediate essential intervention for the newborns. However, these interventions are hampered by factors such as lack of adequately trained staff & hands-on skills; weak referral linkage; stock-out of essential medicines and supplies and poor quality for early postnatal care home visits. Conclusions In order to enhance the quality of newborns healthcare provision, the health-systems constraints at health centres and heath posts level should be fixed to provide the required services for newborns. This requires allocation of adequate resources to tackle health facilities readiness related bottlenecks, such as the frequent stock out or lack of essential supplies, equipment, and medicines, lack of proper space for the service provision, not systematic replenishing of the revised job-aids and maintenance of medical equipment, poor infection prevention including water and sanitation in the maternity wards and newborn corners.

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

“…2018), lack of medicines and equipment such as beds and drugs (Berhe et al. 2017; Birhanu & Mathibe‐Neke, 2022; Carvajal‐Aguirre et al. 2017; Chanie et al.…”

“…2018). Specifically, some staff may have challenges translating knowledge and skills from training to implementation (Birhanu & Mathibe‐Neke, 2022; Morseth et al. 2020), lack updated training (Berhe et al.…”

“…Evidence strength & quality • demanding for peer-reviewed journal articles used for WHO GRADE recommendations as an example 25 -Neke, 2022;Holztrattner et al 2021;Majra & Silan, 2016;Mbalinda et al 2018;Shobo et al 2020). Studies have shown that health education is one of the key factors informing mothers of the benefits of SSC and how to breastfeed after childbirth (Alenchery et al 2018;Holztrattner et al 2021;Shobo et al 2020).…”

“…Professionals should take initiatives to inform the community about SSC, such as broadcasting on radio talk shows (Mbalinda et al 2018). In contrast, the lack of routine antenatal care (Birhanu & Mathibe-Neke, 2022) and breastfeeding counselling (Majra & Silan, 2016) could limit the practice.…”

“…Four studies reported that a lack of teamwork(Alenchery et al 2018;Rana et al 2019;Vail et al 2018) and a delegation system for tasks(Delele et al 2021a) were challenging. The cooperation was often between the paediatrician, gynaecologist and labour room workers(Alenchery et al 2018) and the role of nurses was stressed(Holztrattner et al 2021).The construct of structural characteristics, which referred to the structure, age, level and size of an organisation, was reported by five studies(Berhe et al 2017;Birhanu & Mathibe-Neke, 2022;Fekadu et al 2022;Morseth et al 2020;Vail et al 2018).as a special service(Morseth et al 2020).The construct of implementation climate, which referred to the absorptive capacity for change in an organisation, was identified by five studies. Three studies found that friendly service(Delele et al 2021b;Fekadu et al 2022) and positive staff involvement (Mbalinda et al 2018) could promote EENC implementation.…”