Delele Tadesse Guadu, Biks Gashaw Andargie, Abebe Solomon Mekonnen, Kebede Zemene Tigabu
Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
J Multidiscip Healthc. 2021 Mar 23;14:713-725. doi: 10.2147/JMDH.S300362. eCollection 2021.
Despite the efforts put forth in improving neonatal survival, there is still a high rate of neonatal morbidity and mortality in northwest Ethiopia. Therefore, this study aimed to determine the essential newborn care service readiness scores and explore the health facility-related barriers in North Gondar Zone, Northwest Ethiopia.
A cross-sectional survey of 16 health facilities (14 health centers and two hospitals) and twelve in-depth interviews were included in the study in three randomly selected districts of North Gondar Zone. A pretested health facility inventory questionnaire customized from the World Health Organization (WHO) service readiness assessment tool was used for a facility audit. Basic emergency and essential obstetric and newborn care (BEmONC), and child immunization service readiness scores were determined using unweighted averages according to the WHO guideline. Descriptive statistics were done for the quantitative data, and thematic content analysis was employed using NVivo 12 software for the qualitative data.
All the surveyed health facilities had no specialist medical doctors, and 50% (8/16) of them had no inpatient beds. The overall BEmONC service readiness score was 62.7% (10/16) (95% CI: 34.8, 83.8) and only one facility had all the tracer items. Trained staff and guidelines had a 27.5% (4/16) readiness score, followed by 71.9% (12/16) readiness score for equipment, and 88.6% (14/16) readiness score for medicine and commodities. The overall child immunization service readiness score was 90.3% (15/16) (95% CI: 51.4, 94.7) and eleven facilities (68.8%) had all the tracer items. The immunization service readiness score was higher; 84.4% (14/16) for trained staff and guidelines, 92.8% (15/16) for equipment, and 93.8% (15/16) for medicines and commodities. Unavailability of equipment, shortage of supplies, and lack of respectful and compassionate healthcare practices were the key facility-related barriers compromising essential newborn care service readiness.
The survey revealed that the essential newborn care service readiness score of the health facilities was low, and it calls for improving BEmONC service readiness in particular. Provision of timely training for newly recruited staff, fulfilling essential equipment, and steady supply is imperative.
尽管在提高新生儿存活率方面付出了努力，但埃塞俄比亚西北部的新生儿发病率和死亡率仍然很高。因此，本研究旨在确定北贡德尔地区基本新生儿护理服务的准备情况得分，并探讨与医疗机构相关的障碍，该地区位于埃塞俄比亚西北部。
对北贡德尔地区三个随机选择的地区的16个医疗机构（14个健康中心和两家医院）进行横断面调查，并进行12次深入访谈。使用从世界卫生组织（WHO）服务准备情况评估工具定制的经过预测试的医疗机构清单问卷进行机构审核。根据WHO指南，使用未加权平均值确定基本急诊和基本产科及新生儿护理（BEmONC）以及儿童免疫服务准备情况得分。对定量数据进行描述性统计，对定性数据使用NVivo 12软件进行主题内容分析。
所有接受调查的医疗机构都没有专科医生，其中50%（8/16）没有住院床位。BEmONC服务的总体准备情况得分为62.7%（10/16）（95%置信区间：34.8，83.8），只有一家机构具备所有追踪项目。经过培训的工作人员和指南的准备情况得分为27.5%（4/16），其次设备的准备情况得分为71.9%（12/16），药品和物资的准备情况得分为88.6%（14/16）。儿童免疫服务的总体准备情况得分为90.3%（15/16）（95%置信区间：51.4，94.7），11家机构（68.8%）具备所有追踪项目。免疫服务的准备情况得分更高；经过培训的工作人员和指南为84.4%（14/16），设备为92.8%（15/16），药品和物资为93.8%（15/16）。设备不可用、物资短缺以及缺乏尊重和关爱性的医疗服务做法是影响基本新生儿护理服务准备情况的关键与机构相关的障碍。
调查显示，医疗机构的基本新生儿护理服务准备情况得分较低，尤其需要提高BEmONC服务的准备情况。必须为新招聘的工作人员提供及时培训，配备基本设备，并确保稳定供应。
