Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania
Abstract Background Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets....
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12887-024-04578-5 |
| _version_ | 1797258982547521536 |
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| author | Rebecca E. Penzias Christine Bohne Edith Gicheha Elizabeth M. Molyneux David Gathara Samuel K. Ngwala Evelyn Zimba Ekran Rashid Opeyemi Odedere Olabisi Dosunmu Robert Tillya Josephine Shabani James H. Cross Christian Ochieng Harriet H. Webster Msandeni Chiume Queen Dube John Wainaina Irabi Kassim Grace Irimu Steve Adudans Femi James Olukemi Tongo Veronica Chinyere Ezeaka Nahya Salim Honorati Masanja Maria Oden Rebecca Richards-Kortum Tedbabe Hailegabriel Gagan Gupta Simon Cousens Joy E. Lawn Eric O. Ohuma with the Health Facility Assessment Data Collection Learning Collaborative Group |
| author_facet | Rebecca E. Penzias Christine Bohne Edith Gicheha Elizabeth M. Molyneux David Gathara Samuel K. Ngwala Evelyn Zimba Ekran Rashid Opeyemi Odedere Olabisi Dosunmu Robert Tillya Josephine Shabani James H. Cross Christian Ochieng Harriet H. Webster Msandeni Chiume Queen Dube John Wainaina Irabi Kassim Grace Irimu Steve Adudans Femi James Olukemi Tongo Veronica Chinyere Ezeaka Nahya Salim Honorati Masanja Maria Oden Rebecca Richards-Kortum Tedbabe Hailegabriel Gagan Gupta Simon Cousens Joy E. Lawn Eric O. Ohuma with the Health Facility Assessment Data Collection Learning Collaborative Group |
| author_sort | Rebecca E. Penzias |
| collection | DOAJ |
| description | Abstract Background Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets. Methods A health facility assessment (HFA) tool was co-designed by Newborn Essential Solutions and Technologies (NEST360) and UNICEF with four African governments. Data were collected in 68 NEST360-implementing neonatal units in Kenya, Malawi, Nigeria, and Tanzania (September 2019-March 2021). Two summary scoring approaches were developed: a) standards-based, including items for SSNC service readiness by health system building block (HSBB), and scored on availability and functionality, and b) level-2 + , scoring items on readiness to provide WHO level-2 + clinical interventions. For each scoring approach, scores were aggregated and summarised as a percentage and equally weighted to obtain an overall score by hospital, HSBB, and clinical intervention. Results Of 1508 HFA items, 1043 (69%) were included in standards-based and 309 (20%) in level-2 + scoring. Sixty-eight neonatal units across four countries had median standards-based scores of 51% [IQR 48–57%] at baseline, with variation by country: 62% [IQR 59–66%] in Kenya, 49% [IQR 46–51%] in Malawi, 50% [IQR 42–58%] in Nigeria, and 55% [IQR 53–62%] in Tanzania. The lowest scoring was family-centred care [27%, IQR 18–40%] with governance highest scoring [76%, IQR 71–82%]. For level-2 + scores, the overall median score was 41% [IQR 35–51%] with variation by country: 50% [IQR 44–53%] in Kenya, 41% [IQR 35–50%] in Malawi, 33% [IQR 27–37%] in Nigeria, and 41% [IQR 32–52%] in Tanzania. Readiness to provide antibiotics by culture report was the highest-scoring intervention [58%, IQR 50–75%] and neonatal encephalopathy management was the lowest-scoring [21%, IQR 8–42%]. In both methods, overall scores were low (< 50%) for 27 neonatal units in standards-based scoring and 48 neonatal units in level-2 + scoring. No neonatal unit achieved high scores of > 75%. Discussion Two scoring approaches reveal gaps in SSNC readiness with no neonatal units achieving high scores (> 75%). Government-led quality improvement teams can use these summary scores to identify areas for health systems change. Future analyses could determine which items are most directly linked with quality SSNC and newborn outcomes. |
| first_indexed | 2024-04-24T23:02:11Z |
| format | Article |
| id | doaj.art-07eedfb2670a466fa9a59273704ecd5d |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-04-24T23:02:11Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-07eedfb2670a466fa9a59273704ecd5d2024-03-17T12:38:28ZengBMCBMC Pediatrics1471-24312024-03-0123S211710.1186/s12887-024-04578-5Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and TanzaniaRebecca E. Penzias0Christine Bohne1Edith Gicheha2Elizabeth M. Molyneux3David Gathara4Samuel K. Ngwala5Evelyn Zimba6Ekran Rashid7Opeyemi Odedere8Olabisi Dosunmu9Robert Tillya10Josephine Shabani11James H. Cross12Christian Ochieng13Harriet H. Webster14Msandeni Chiume15Queen Dube16John Wainaina17Irabi Kassim18Grace Irimu19Steve Adudans20Femi James21Olukemi Tongo22Veronica Chinyere Ezeaka23Nahya Salim24Honorati Masanja25Maria Oden26Rebecca Richards-Kortum27Tedbabe Hailegabriel28Gagan Gupta29Simon Cousens30Joy E. Lawn31Eric O. Ohuma32with the Health Facility Assessment Data Collection Learning Collaborative GroupMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineRice360 Institute for Global Health Technologies, Rice UniversityRice360 Institute for Global Health Technologies, Rice UniversityKamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi)Maternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineKamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi)Rice360 Institute for Global Health Technologies, Rice UniversityRice360 Institute for Global Health Technologies, Rice UniversityRice360 Institute for Global Health Technologies, Rice UniversityAPIN Public Health InitiativesIfakara Health InstituteIfakara Health InstituteMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineKamuzu University of Health Sciences (Formerly College of Medicine, University of Malawi)Ministry of HealthKenya Medical Research Institute (KEMRI)-Wellcome TrustIfakara Health InstituteDepartment of Paediatrics and Child Health, University of NairobiAcademy for Novel Channels in Health and Operations Research (ACANOVA) AfricaNewborn Branch, Federal Ministry of HealthDepartment of Paediatrics, College of Medicine, University of IbadanDepartment of Paediatrics, College of Medicine, University of LagosDepartment of Paediatrics and Child Health, Muhimbili University of Health and Allied SciencesIfakara Health InstituteRice360 Institute for Global Health Technologies, Rice UniversityRice360 Institute for Global Health Technologies, Rice UniversityProgram Group, Health Programme UNICEF HeadquartersProgram Group, Health Programme UNICEF HeadquartersMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineMaternal, Adolescent, Reproductive, & Child Health Centre, London School of Hygiene & Tropical MedicineAbstract Background Service readiness tools are important for assessing hospital capacity to provide quality small and sick newborn care (SSNC). Lack of summary scoring approaches for SSNC service readiness means we are unable to track national targets such as the Every Newborn Action Plan targets. Methods A health facility assessment (HFA) tool was co-designed by Newborn Essential Solutions and Technologies (NEST360) and UNICEF with four African governments. Data were collected in 68 NEST360-implementing neonatal units in Kenya, Malawi, Nigeria, and Tanzania (September 2019-March 2021). Two summary scoring approaches were developed: a) standards-based, including items for SSNC service readiness by health system building block (HSBB), and scored on availability and functionality, and b) level-2 + , scoring items on readiness to provide WHO level-2 + clinical interventions. For each scoring approach, scores were aggregated and summarised as a percentage and equally weighted to obtain an overall score by hospital, HSBB, and clinical intervention. Results Of 1508 HFA items, 1043 (69%) were included in standards-based and 309 (20%) in level-2 + scoring. Sixty-eight neonatal units across four countries had median standards-based scores of 51% [IQR 48–57%] at baseline, with variation by country: 62% [IQR 59–66%] in Kenya, 49% [IQR 46–51%] in Malawi, 50% [IQR 42–58%] in Nigeria, and 55% [IQR 53–62%] in Tanzania. The lowest scoring was family-centred care [27%, IQR 18–40%] with governance highest scoring [76%, IQR 71–82%]. For level-2 + scores, the overall median score was 41% [IQR 35–51%] with variation by country: 50% [IQR 44–53%] in Kenya, 41% [IQR 35–50%] in Malawi, 33% [IQR 27–37%] in Nigeria, and 41% [IQR 32–52%] in Tanzania. Readiness to provide antibiotics by culture report was the highest-scoring intervention [58%, IQR 50–75%] and neonatal encephalopathy management was the lowest-scoring [21%, IQR 8–42%]. In both methods, overall scores were low (< 50%) for 27 neonatal units in standards-based scoring and 48 neonatal units in level-2 + scoring. No neonatal unit achieved high scores of > 75%. Discussion Two scoring approaches reveal gaps in SSNC readiness with no neonatal units achieving high scores (> 75%). Government-led quality improvement teams can use these summary scores to identify areas for health systems change. Future analyses could determine which items are most directly linked with quality SSNC and newborn outcomes.https://doi.org/10.1186/s12887-024-04578-5NewbornLow- and middle-income countriesInpatient careService readinessHealth facility assessmentSmall and sick newborn care |
| spellingShingle | Rebecca E. Penzias Christine Bohne Edith Gicheha Elizabeth M. Molyneux David Gathara Samuel K. Ngwala Evelyn Zimba Ekran Rashid Opeyemi Odedere Olabisi Dosunmu Robert Tillya Josephine Shabani James H. Cross Christian Ochieng Harriet H. Webster Msandeni Chiume Queen Dube John Wainaina Irabi Kassim Grace Irimu Steve Adudans Femi James Olukemi Tongo Veronica Chinyere Ezeaka Nahya Salim Honorati Masanja Maria Oden Rebecca Richards-Kortum Tedbabe Hailegabriel Gagan Gupta Simon Cousens Joy E. Lawn Eric O. Ohuma with the Health Facility Assessment Data Collection Learning Collaborative Group Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania BMC Pediatrics Newborn Low- and middle-income countries Inpatient care Service readiness Health facility assessment Small and sick newborn care |
| title | Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania |
| title_full | Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania |
| title_fullStr | Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania |
| title_full_unstemmed | Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania |
| title_short | Quantifying health facility service readiness for small and sick newborn care: comparing standards-based and WHO level-2 + scoring for 64 hospitals implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania |
| title_sort | quantifying health facility service readiness for small and sick newborn care comparing standards based and who level 2 scoring for 64 hospitals implementing with nest360 in kenya malawi nigeria and tanzania |
| topic | Newborn Low- and middle-income countries Inpatient care Service readiness Health facility assessment Small and sick newborn care |
| url | https://doi.org/10.1186/s12887-024-04578-5 |
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