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Research article
Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia
Binyam Fekadu Desta
JSI Research and Training Institute, Inc
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2146-9516
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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.
Keywords
Essential newborn care, ENC, Primary health care, Providers’ attitude
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Yunis Mussema Abdella
commented on 06 December, 2020
Great article in terms of choice of topic, a burning one and timely for the country. the abstract summarizes the article well. the methodology section is very clear except that it does not include limitation of the study (including the fact that this is based on a routine records which might not be accurate as to the actual practice of the ENC) which was not also found in other sections. A sentence at the end of the first paragraph of the data collection section under methodology used a future tense which may be an oversight while writing that section of the report from the original proposal. The result section clearly described the finding and the discussion was great as it compared relevant literature. the conclusion summarized some of the findings and discussions but included some elements which were not entirely described in the result and discussion including commitment of health workers and role of health facility mangers. i think this section may need to be revisited to ensure better coherence and alignment with the previous sections and the finding.
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CURRENT STATUS: Under Review
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Posted 18 Jun, 2020
Community comments: 2
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On 03 Jun, 2020
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Subject Areas
Sexual & Reproductive Medicine
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This preprint is under consideration at BMC Pregnancy and Childbirth. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia
Binyam Fekadu Desta
JSI Research and Training Institute, Inc
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2146-9516
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 Jun, 2020
Community comments: 2
Reviewers invited
Invitations sent on 27 Aug, 2020
Editor assigned
On 03 Jun, 2020
Editor invited
On 02 Jun, 2020
Submission checks complete
On 19 May, 2020
Metrics
Comments: 2
PDF Downloads: ...
HTML Views: ...
Subject Areas
Sexual & Reproductive Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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.
Yunis Mussema Abdella
commented on 06 December, 2020
Great article in terms of choice of topic, a burning one and timely for the country. the abstract summarizes the article well. the methodology section is very clear except that it does not include limitation of the study (including the fact that this is based on a routine records which might not be accurate as to the actual practice of the ENC) which was not also found in other sections. A sentence at the end of the first paragraph of the data collection section under methodology used a future tense which may be an oversight while writing that section of the report from the original proposal. The result section clearly described the finding and the discussion was great as it compared relevant literature. the conclusion summarized some of the findings and discussions but included some elements which were not entirely described in the result and discussion including commitment of health workers and role of health facility mangers. i think this section may need to be revisited to ensure better coherence and alignment with the previous sections and the finding.
View 1 reply
Binyam
replied on 13 December, 2020
Thank you for the feedback. We'll incorporate the suggestions in the second version.
Binyam
replied on 13 December, 2020
Thank you for the feedback. We'll incorporate the suggestions in the second version.