Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda
Abstract Background The neonatal mortality rate in Uganda has barely changed over the past decades, estimated at 28/1000 and 27/1000 live births in 2006 and 2016 respectively. The survivors have a higher risk of developing neurodevelopmental disabilities (NDD) due to brain insults from perinatal com...
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| Format: | Article |
| Language: | English |
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BMC
2022-03-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12913-022-07693-0 |
| _version_ | 1818917967410233344 |
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| author | Gertrude Namazzi Helena Hildenwall Grace Ndeezi Paul Mubiri Christine Nalwadda Angelina Kakooza-Mwesige Peter Waiswa James K. Tumwine |
| author_facet | Gertrude Namazzi Helena Hildenwall Grace Ndeezi Paul Mubiri Christine Nalwadda Angelina Kakooza-Mwesige Peter Waiswa James K. Tumwine |
| author_sort | Gertrude Namazzi |
| collection | DOAJ |
| description | Abstract Background The neonatal mortality rate in Uganda has barely changed over the past decades, estimated at 28/1000 and 27/1000 live births in 2006 and 2016 respectively. The survivors have a higher risk of developing neurodevelopmental disabilities (NDD) due to brain insults from perinatal complications related to poor quality of health services during pregnancy, around the time of birth, and during the postnatal period. This study aimed to assess health facility readiness to care for high risk newborn babies in order to inform programming that fosters early childhood development in eastern Uganda. Methods A cross sectional study of 6 hospitals and 10 higher level health centers that offer comprehensive maternal and newborn care was carried out in February 2020 in eastern Uganda. A World Health Organization Service Availability and Readiness Assessment tool (SARA) was adapted and used to assess the health facility readiness to manage maternal and neonatal conditions that are related to NDD. In addition, 201 mothers of high risk newborn babies were interviewed on their satisfaction with health services received. Readiness scores were derived from percentage average facilities with available infrastructure and essential medical commodities to manage neonatal complications. Descriptive statistics were computed for client satisfaction with service provision, and p values used to compare private not for profit to public health facilities. Results There was limited availability in numbers and skilled human resource especially the neonatal nurses. Hospitals and health centers scored least in preterm and hypothermia care, with averages of 38% and 18% respectively. The highest scores were in essential newborn care, with readiness of 78% and 85% for hospitals and health centers, followed by resuscitation at 78% and 77%, respectively. There were no guidelines on positive interaction with newborn babies to foster neurodevelopment. The main cause of admission to neonatal care units was birth asphyxia followed by prematurity, indicative of intrapartum care challenges. The overall client satisfaction with health services was higher in private not for profit facilities at 91% compared to public hospitals at 73%, p = 0.017. Conclusion Health facility readiness was inadequate in management of preterm complications. Efforts should, therefore, be geared to improving availability of inputs and quality of emergency obstetric and newborn care in order to manage high risk newborns and reduce the burden of NDD in this setting. |
| first_indexed | 2024-12-20T00:42:29Z |
| format | Article |
| id | doaj.art-374a4a6df0584500a1c9eedf114f09a8 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-20T00:42:29Z |
| publishDate | 2022-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-374a4a6df0584500a1c9eedf114f09a82022-12-21T19:59:30ZengBMCBMC Health Services Research1472-69632022-03-0122111310.1186/s12913-022-07693-0Health facility readiness to care for high risk newborn babies for early childhood development in eastern UgandaGertrude Namazzi0Helena Hildenwall1Grace Ndeezi2Paul Mubiri3Christine Nalwadda4Angelina Kakooza-Mwesige5Peter Waiswa6James K. Tumwine7Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere UniversityAstrid Lindgren Children’s Hospital, Karolinska University HospitalDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere UniversityDepartment of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Community Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere UniversityDepartment of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, Makerere UniversityDepartment of Paediatrics and Child Health, School of Medicine, College of Health Sciences, Makerere UniversityAbstract Background The neonatal mortality rate in Uganda has barely changed over the past decades, estimated at 28/1000 and 27/1000 live births in 2006 and 2016 respectively. The survivors have a higher risk of developing neurodevelopmental disabilities (NDD) due to brain insults from perinatal complications related to poor quality of health services during pregnancy, around the time of birth, and during the postnatal period. This study aimed to assess health facility readiness to care for high risk newborn babies in order to inform programming that fosters early childhood development in eastern Uganda. Methods A cross sectional study of 6 hospitals and 10 higher level health centers that offer comprehensive maternal and newborn care was carried out in February 2020 in eastern Uganda. A World Health Organization Service Availability and Readiness Assessment tool (SARA) was adapted and used to assess the health facility readiness to manage maternal and neonatal conditions that are related to NDD. In addition, 201 mothers of high risk newborn babies were interviewed on their satisfaction with health services received. Readiness scores were derived from percentage average facilities with available infrastructure and essential medical commodities to manage neonatal complications. Descriptive statistics were computed for client satisfaction with service provision, and p values used to compare private not for profit to public health facilities. Results There was limited availability in numbers and skilled human resource especially the neonatal nurses. Hospitals and health centers scored least in preterm and hypothermia care, with averages of 38% and 18% respectively. The highest scores were in essential newborn care, with readiness of 78% and 85% for hospitals and health centers, followed by resuscitation at 78% and 77%, respectively. There were no guidelines on positive interaction with newborn babies to foster neurodevelopment. The main cause of admission to neonatal care units was birth asphyxia followed by prematurity, indicative of intrapartum care challenges. The overall client satisfaction with health services was higher in private not for profit facilities at 91% compared to public hospitals at 73%, p = 0.017. Conclusion Health facility readiness was inadequate in management of preterm complications. Efforts should, therefore, be geared to improving availability of inputs and quality of emergency obstetric and newborn care in order to manage high risk newborns and reduce the burden of NDD in this setting.https://doi.org/10.1186/s12913-022-07693-0NeurodevelopmentFacility readinessHigh risk newbornsEssential newborn careBirth asphyxiaPreterm |
| spellingShingle | Gertrude Namazzi Helena Hildenwall Grace Ndeezi Paul Mubiri Christine Nalwadda Angelina Kakooza-Mwesige Peter Waiswa James K. Tumwine Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda BMC Health Services Research Neurodevelopment Facility readiness High risk newborns Essential newborn care Birth asphyxia Preterm |
| title | Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda |
| title_full | Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda |
| title_fullStr | Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda |
| title_full_unstemmed | Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda |
| title_short | Health facility readiness to care for high risk newborn babies for early childhood development in eastern Uganda |
| title_sort | health facility readiness to care for high risk newborn babies for early childhood development in eastern uganda |
| topic | Neurodevelopment Facility readiness High risk newborns Essential newborn care Birth asphyxia Preterm |
| url | https://doi.org/10.1186/s12913-022-07693-0 |
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