Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal

Kc, Ashish; Singh, Dipendra Raman; Upadhyaya, Madan Kumar; Budhathoki, Shyam Sundar; Gurung, Abhishek

doi:10.1007/s10995-019-02846-w

Cited by 31 publications

(33 citation statements)

References 14 publications

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“…The overall readiness score to provide BEmONC in Northwest Ethiopia was lower than the national figure and other similar studies in Low and Middle-Income Countries (LMIC). 10,[14][15][16][17][18] The 62.7% (10/16) overall BEmONC service readiness score refers to the fact that only 62.7% of all facilities in the study area were ready to provide BEmONC as per the WHO requirements 13 such as trained staff and guidelines, equipment, and medicines and commodities. There is only one health facility which had all the tracer items as per WHO guideline.…”

Section: Discussionmentioning

confidence: 99%

“…supported by similar studies in Bangladesh, Madagascar, and Tanzania. 15,16,18 Arguably, equipment, medicines, and commodities are relatively available in hospitals. The availability of equipment and supplies could lead to high patient flow, this would help for the retention of complex skills of healthcare workers, and these all issues could attribute to a better hospital BEmONC service readiness score.…”

Section: Dovepressmentioning

confidence: 99%

“…However, a similar study in Bangladesh and Nepal showed that more than 80% of the health facilities had essential equipment. 14,16 The absence of such equipment has a clear effect on screening services during childbirth care. This was a common challenge identified by other studies.…”

Section: Dovepressmentioning

confidence: 99%

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Essential Newborn Care Service Readiness and Barriers in Northwest Ethiopia: A Descriptive Survey and Qualitative Study

Delele¹,

Biks²,

Abebe³

et al. 2021

JMDH

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Background: Despite the efforts put forth in improving neonatal survival, there is still a high rate of neonatal morbidity and mortality in northwest Ethiopia. Therefore, this study aimed to determine the essential newborn care service readiness scores and explore the health facility-related barriers in North Gondar Zone, Northwest Ethiopia. Methods: A cross-sectional survey of 16 health facilities (14 health centers and two hospitals) and twelve in-depth interviews were included in the study in three randomly selected districts of North Gondar Zone. A pretested health facility inventory questionnaire customized from the World Health Organization (WHO) service readiness assessment tool was used for a facility audit. Basic emergency and essential obstetric and newborn care (BEmONC), and child immunization service readiness scores were determined using unweighted averages according to the WHO guideline. Descriptive statistics were done for the quantitative data, and thematic content analysis was employed using NVivo 12 software for the qualitative data. Results: All the surveyed health facilities had no specialist medical doctors, and 50% (8/16) of them had no inpatient beds. The overall BEmONC service readiness score was 62.7% (10/ 16) (95% CI: 34.8, 83.8) and only one facility had all the tracer items. Trained staff and guidelines had a 27.5% (4/16) readiness score, followed by 71.9% (12/16) readiness score for equipment, and 88.6% (14/16) readiness score for medicine and commodities. The overall child immunization service readiness score was 90.3% (15/16) (95% CI: 51.4, 94.7) and eleven facilities (68.8%) had all the tracer items. The immunization service readiness score was higher; 84.4% (14/16) for trained staff and guidelines, 92.8% (15/16) for equipment, and 93.8% (15/16) for medicines and commodities. Unavailability of equipment, shortage of supplies, and lack of respectful and compassionate healthcare practices were the key facilityrelated barriers compromising essential newborn care service readiness. Conclusions for Practice: The survey revealed that the essential newborn care service readiness score of the health facilities was low, and it calls for improving BEmONC service readiness in particular. Provision of timely training for newly recruited staff, fulfilling essential equipment, and steady supply is imperative.

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Section: Discussionmentioning

confidence: 99%

Section: Dovepressmentioning

confidence: 99%

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Essential Newborn Care Service Readiness and Barriers in Northwest Ethiopia: A Descriptive Survey and Qualitative Study

Delele¹,

Biks²,

Abebe³

et al. 2021

JMDH

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“…26 Despite, the national strategy to integrate STI services with HIV and ANC services, the lower readiness of facilities to deliver STI services compared with HIV or ANC services indicates that the STI services have not been fully integrated with these services. 27 …”

Section: Discussionmentioning

confidence: 99%

Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

Acharya¹,

Thapa

Bhattarai

et al. 2020

BMJ Open

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ObjectiveWe assessed the availability and readiness of health facilities to provide sexually transmitted infections (STI) and HIV testing and counselling (HTC) services in Nepal.DesignThis was a cross-sectional study.SettingWe used data from the most recent nationally representative Nepal Health Facility Survey (NHFS) 2015. A total of 963 health facilities were surveyed with 97% response rate.Primary and secondary outcome measuresThe primary outcome of this study was to assess the availability and readiness of health facilities to provide STI and HTC services using the WHO Service Availability and Readiness Assessment (SARA) manual.ResultsNearly three-fourths (73.8%) and less than one-tenth (5.9%) of health facilities reported providing STI and HTC services, respectively. The mean readiness score of STI and HTC services was 26.2% and 68.9%, respectively. The readiness scores varied significantly according to the managing authority (private vs public) for both STI and HTC services. Interestingly, health facilities with external supervision had better service readiness scores for STI services that were almost four points higher than compared with those facilities with no external supervision. Regarding HTC services, service readiness was lower at private hospitals (32.9 points lower) compared to government hospitals. Unlike STI services, the readiness of facilities to provide HTC services was higher (4.8 point higher) at facilities which performed quality assurance.ConclusionThe facility readiness for HTC service is higher than that for STI services. There are persistent gaps in staff, guidelines and medicine and commodities across both services. Government of Nepal should focus on ensuring constant supervision and quality assurance, as these were among the determining factors for facility readiness.

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“…Having the required commodities for care in delivery rooms was a determinant factor for consistent delivery of ENC. In many of the cases -as demonstrated by other studies -essential medicines for newborn care, such as vitamin K (29) (9) (19), chlorhexidine (30) (19) and tetracycline eye ointment (19) are not available in similar settings. Availability of essential drugs for care is also dependent on various factors, such as supply chain logistics, provider attitude, and restrictions on use (31).…”

Section: Discussionmentioning

confidence: 99%

Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

Desta

Beshir

Tafesse

et al. 2020

Preprint

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Background: Essential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Although a minimum package of proven interventions to reduce newborn mortality have been adopted, countries are still challenged by multiple system related problems. Methods: This study employed a retrospective cross-sectional study design and used program monitoring data collected from 425 facilities between October and December 2019. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p<0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders. Results: A total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors - availability of essential obstetrics drugs in delivery rooms, high CSC performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of CD-ENC was consistent partograph use, recording an odds ratio of 2.66. Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 times higher odds of exhibiting consistent delivery of ENC. Conclusion: Health worker commitment to provide ENC is linked to the practices and platforms created by health facility management. Health facility managers should establish a platform or mechanism to enhance providers relationship with their clients as well as comprehensive tools to remind health workers’ responsibilities with regards to ENC. In addition, the health service managers should also consider availing the required supplies and drugs closer to the service delivery rooms and tables.

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Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal

Cited by 31 publications

References 14 publications

Essential Newborn Care Service Readiness and Barriers in Northwest Ethiopia: A Descriptive Survey and Qualitative Study

Essential Newborn Care Service Readiness and Barriers in Northwest Ethiopia: A Descriptive Survey and Qualitative Study

Availability and readiness to provide sexually transmitted infections and HIV testing and counselling services in Nepal: evidence from comprehensive health facility survey

Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

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