An assessment of immediate newborn care readiness and availability in Nepal
Background Global neonatal mortality necessitates access to immediate newborn care interventions. In Nepal, disparities persist in the readiness and availability of newborn care services within health facilities. Objective This study aimed to assess this status and compare facilities that had implem...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2023-12-01
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| Series: | Global Health Action |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/16549716.2023.2289735 |
| _version_ | 1797351896861638656 |
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| author | Ranjan Dhungana Mala Chalise Robert B. Clark |
| author_facet | Ranjan Dhungana Mala Chalise Robert B. Clark |
| author_sort | Ranjan Dhungana |
| collection | DOAJ |
| description | Background Global neonatal mortality necessitates access to immediate newborn care interventions. In Nepal, disparities persist in the readiness and availability of newborn care services within health facilities. Objective This study aimed to assess this status and compare facilities that had implemented an intensive newborn resuscitation capacity building and retention programme in the past five years with those that had not. Methods Our observational cross-sectional study involved 154 health facilities across Nepal. Through on-site inspections and maternal log reviews, we evaluated the immediate newborn care readiness and availability. Results The mean immediate newborn care intervention availability score of 52.8% (SE = 21.5) and the readiness score averaged 79.6% (SE = 12.3). Encouragingly, 96% of facilities ensured newborns were dried and wrapped for warmth, and 69.9% provided newborn resuscitation. Practices such as delayed cord clamping (42.0%), skin-to-skin contact (28.6%), and early breastfeeding (63.5%) showed room for improvement. Only 16.1% of health facilities administered Vitamin K1 prophylaxis.Domain-specific scores demonstrated a high level of facility readiness in infrastructure (97.5%), medicine, equipment, and supplies (90.6%), and staff training (90.9%), but a lower score for neonatal resuscitation aids (28.8%). Disparities in readiness and availability were evident, with rural areas and the Madhesh province reporting lower scores. Variations among health facility types revealed provincial and private hospitals outperforming local-level facilities. A positive association was observed between the LDSC/SSN mentoring programme and both the readiness and availability of immediate newborn care services. Conclusion This study highlights the gap between healthcare facility readiness and the actual availability of immediate newborn care interventions in Nepal. Addressing disparities and barriers, particularly in rural areas and local-level facilities, is crucial for improving neonatal survival. The positive link between the LDSC/SSN programme and service availability and facility readiness emphasises the significance of targeted training and mentorship programmes in enhancing newborn care across Nepal. |
| first_indexed | 2024-03-08T13:07:20Z |
| format | Article |
| id | doaj.art-737c8617178e48b5b880f73661abef3e |
| institution | Directory Open Access Journal |
| issn | 1654-9880 |
| language | English |
| last_indexed | 2024-03-08T13:07:20Z |
| publishDate | 2023-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj.art-737c8617178e48b5b880f73661abef3e2024-01-18T15:58:24ZengTaylor & Francis GroupGlobal Health Action1654-98802023-12-0116110.1080/16549716.2023.22897352289735An assessment of immediate newborn care readiness and availability in NepalRanjan Dhungana0Mala Chalise1Robert B. Clark2Children’s Medical MissionChildren’s Medical MissionBrigham Young UniversityBackground Global neonatal mortality necessitates access to immediate newborn care interventions. In Nepal, disparities persist in the readiness and availability of newborn care services within health facilities. Objective This study aimed to assess this status and compare facilities that had implemented an intensive newborn resuscitation capacity building and retention programme in the past five years with those that had not. Methods Our observational cross-sectional study involved 154 health facilities across Nepal. Through on-site inspections and maternal log reviews, we evaluated the immediate newborn care readiness and availability. Results The mean immediate newborn care intervention availability score of 52.8% (SE = 21.5) and the readiness score averaged 79.6% (SE = 12.3). Encouragingly, 96% of facilities ensured newborns were dried and wrapped for warmth, and 69.9% provided newborn resuscitation. Practices such as delayed cord clamping (42.0%), skin-to-skin contact (28.6%), and early breastfeeding (63.5%) showed room for improvement. Only 16.1% of health facilities administered Vitamin K1 prophylaxis.Domain-specific scores demonstrated a high level of facility readiness in infrastructure (97.5%), medicine, equipment, and supplies (90.6%), and staff training (90.9%), but a lower score for neonatal resuscitation aids (28.8%). Disparities in readiness and availability were evident, with rural areas and the Madhesh province reporting lower scores. Variations among health facility types revealed provincial and private hospitals outperforming local-level facilities. A positive association was observed between the LDSC/SSN mentoring programme and both the readiness and availability of immediate newborn care services. Conclusion This study highlights the gap between healthcare facility readiness and the actual availability of immediate newborn care interventions in Nepal. Addressing disparities and barriers, particularly in rural areas and local-level facilities, is crucial for improving neonatal survival. The positive link between the LDSC/SSN programme and service availability and facility readiness emphasises the significance of targeted training and mentorship programmes in enhancing newborn care across Nepal.http://dx.doi.org/10.1080/16549716.2023.2289735newborn resuscitationimmediate newborn carehealth facility readinessneonatal morbiditynewborn care capacity |
| spellingShingle | Ranjan Dhungana Mala Chalise Robert B. Clark An assessment of immediate newborn care readiness and availability in Nepal Global Health Action newborn resuscitation immediate newborn care health facility readiness neonatal morbidity newborn care capacity |
| title | An assessment of immediate newborn care readiness and availability in Nepal |
| title_full | An assessment of immediate newborn care readiness and availability in Nepal |
| title_fullStr | An assessment of immediate newborn care readiness and availability in Nepal |
| title_full_unstemmed | An assessment of immediate newborn care readiness and availability in Nepal |
| title_short | An assessment of immediate newborn care readiness and availability in Nepal |
| title_sort | assessment of immediate newborn care readiness and availability in nepal |
| topic | newborn resuscitation immediate newborn care health facility readiness neonatal morbidity newborn care capacity |
| url | http://dx.doi.org/10.1080/16549716.2023.2289735 |
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