Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study
Abstract Background Increasingly, neonatal mortality is concentrated in settings of conflict and political instability. To promote evidence-based practices, an interagency collaboration developed the Newborn Health in Humanitarian Settings: Field Guide. The essential newborn care component of the Fi...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Pediatrics |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12887-020-02120-x |
| _version_ | 1819148861907664896 |
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| author | Ribka Amsalu Catherine N. Morris Michelle Hynes Hussein Jama Had Joseph Adive Seriki Kate Meehan Stephen Ayella Sammy O. Barasa Alexia Couture Anna Myers Binyam Gebru |
| author_facet | Ribka Amsalu Catherine N. Morris Michelle Hynes Hussein Jama Had Joseph Adive Seriki Kate Meehan Stephen Ayella Sammy O. Barasa Alexia Couture Anna Myers Binyam Gebru |
| author_sort | Ribka Amsalu |
| collection | DOAJ |
| description | Abstract Background Increasingly, neonatal mortality is concentrated in settings of conflict and political instability. To promote evidence-based practices, an interagency collaboration developed the Newborn Health in Humanitarian Settings: Field Guide. The essential newborn care component of the Field Guide was operationalized with the use of an intervention package encompassing the training of health workers, newborn kit provisions and the installation of a newborn register. Methods We conducted a quasi-experimental prepost study to test the effectiveness of the intervention package on the composite outcome of essential newborn care from August 2016 to December 2018 in Bossaso, Somalia. Data from the observation of essential newborn care practices, evaluation of providers’ knowledge and skills, postnatal interviews, and qualitative information were analyzed. Differences in two-proportion z-tests were used to estimate change in essential newborn care practices. A generalized estimating equation was applied to account for clustering of practice at the health facility level. Results Among the 690 pregnant women in labor who sought care at the health facilities, 89.9% (n = 620) were eligible for inclusion, 84.7% (n = 525) were enrolled, and newborn outcomes were ascertained in 79.8% (n = 419). Providers’ knowledge improved from pre to posttraining, with a mean difference in score of + 11.9% (95% CI: 7.2, 16.6, p-value < 0.001) and from posttraining to 18-months after training with a mean difference of + 10.9% (95% CI: 4.7, 17.0, p-value < 0.001). The proportion of newborns who received two or more essential newborn care practices (skin-to-skin contact, early breastfeeding, and dry cord care) improved from 19.9% (95% CI: 4.9, 39.7) to 94.7% (95% CI: 87.7, 100.0). In the adjusted model that accounted for clustering at health facilities, the odds of receiving two or more essential newborn practices was 64.5 (95% CI: 15.8, 262.6, p-value < 0.001) postintervention compared to preintervention. Predischarge education offered to mothers on breastfeeding 16.5% (95% CI: 11.8, 21.1) vs 44.2% (95% CI: 38.2, 50.3) and newborn illness danger signs 9.1% (95% CI: 5.4, 12.7) vs 5.0% (95% CI: 2.4, 7.7) remained suboptimal. Conclusions The intervention package was feasible and effective in improving essential newborn care. Knowledge and skills gained after training were mostly retained at the 18-month follow-up. |
| first_indexed | 2024-12-22T13:52:27Z |
| format | Article |
| id | doaj.art-ce9c7316408c44e3a6e58db61ed3d41b |
| institution | Directory Open Access Journal |
| issn | 1471-2431 |
| language | English |
| last_indexed | 2024-12-22T13:52:27Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pediatrics |
| spelling | doaj.art-ce9c7316408c44e3a6e58db61ed3d41b2022-12-21T18:23:38ZengBMCBMC Pediatrics1471-24312020-05-0120111410.1186/s12887-020-02120-xEffectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention studyRibka Amsalu0Catherine N. Morris1Michelle Hynes2Hussein Jama Had3Joseph Adive Seriki4Kate Meehan5Stephen Ayella6Sammy O. Barasa7Alexia Couture8Anna Myers9Binyam Gebru10Department of Global Health, Save the ChildrenDepartment of Global Health, Save the ChildrenCenter for Global Health. US Centers for Disease Control and PreventionSave the Children InternationalSave the Children InternationalCenter for Global Health. US Centers for Disease Control and PreventionSave the Children InternationalKenya Medical Training CollegeCenter for Global Health. US Centers for Disease Control and PreventionIndependent consultantSave the Children InternationalAbstract Background Increasingly, neonatal mortality is concentrated in settings of conflict and political instability. To promote evidence-based practices, an interagency collaboration developed the Newborn Health in Humanitarian Settings: Field Guide. The essential newborn care component of the Field Guide was operationalized with the use of an intervention package encompassing the training of health workers, newborn kit provisions and the installation of a newborn register. Methods We conducted a quasi-experimental prepost study to test the effectiveness of the intervention package on the composite outcome of essential newborn care from August 2016 to December 2018 in Bossaso, Somalia. Data from the observation of essential newborn care practices, evaluation of providers’ knowledge and skills, postnatal interviews, and qualitative information were analyzed. Differences in two-proportion z-tests were used to estimate change in essential newborn care practices. A generalized estimating equation was applied to account for clustering of practice at the health facility level. Results Among the 690 pregnant women in labor who sought care at the health facilities, 89.9% (n = 620) were eligible for inclusion, 84.7% (n = 525) were enrolled, and newborn outcomes were ascertained in 79.8% (n = 419). Providers’ knowledge improved from pre to posttraining, with a mean difference in score of + 11.9% (95% CI: 7.2, 16.6, p-value < 0.001) and from posttraining to 18-months after training with a mean difference of + 10.9% (95% CI: 4.7, 17.0, p-value < 0.001). The proportion of newborns who received two or more essential newborn care practices (skin-to-skin contact, early breastfeeding, and dry cord care) improved from 19.9% (95% CI: 4.9, 39.7) to 94.7% (95% CI: 87.7, 100.0). In the adjusted model that accounted for clustering at health facilities, the odds of receiving two or more essential newborn practices was 64.5 (95% CI: 15.8, 262.6, p-value < 0.001) postintervention compared to preintervention. Predischarge education offered to mothers on breastfeeding 16.5% (95% CI: 11.8, 21.1) vs 44.2% (95% CI: 38.2, 50.3) and newborn illness danger signs 9.1% (95% CI: 5.4, 12.7) vs 5.0% (95% CI: 2.4, 7.7) remained suboptimal. Conclusions The intervention package was feasible and effective in improving essential newborn care. Knowledge and skills gained after training were mostly retained at the 18-month follow-up.http://link.springer.com/article/10.1186/s12887-020-02120-xEssential newborn careHumanitarian emergenciesConflictClinical trainingSomalia |
| spellingShingle | Ribka Amsalu Catherine N. Morris Michelle Hynes Hussein Jama Had Joseph Adive Seriki Kate Meehan Stephen Ayella Sammy O. Barasa Alexia Couture Anna Myers Binyam Gebru Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study BMC Pediatrics Essential newborn care Humanitarian emergencies Conflict Clinical training Somalia |
| title | Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study |
| title_full | Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study |
| title_fullStr | Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study |
| title_full_unstemmed | Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study |
| title_short | Effectiveness of clinical training on improving essential newborn care practices in Bossaso, Somalia: a pre and postintervention study |
| title_sort | effectiveness of clinical training on improving essential newborn care practices in bossaso somalia a pre and postintervention study |
| topic | Essential newborn care Humanitarian emergencies Conflict Clinical training Somalia |
| url | http://link.springer.com/article/10.1186/s12887-020-02120-x |
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