JSI/USAID Transform: Primary Health Care Activity, Addis Ababa, Ethiopia.
Ethiop J Health Sci. 2021 Mar;31(2):321-328. doi: 10.4314/ejhs.v31i2.15.
The Ethiopian neonatal mortality has not shown much progress over the years. In light of this, the country has introduced interventions such as the utilization of newborn corners and neonatal intensive care units to avert preventable neonatal deaths. This study was conducted to assess readiness of primary hospitals in providing neonatal intensive care services.
A health facility based cross-sectional study design was employed where data were collected using both prospective and retrospective techniques using a format adapted from national documents. SPSS version 25 was used for data entry and analysis using descriptive statistics.
Data were collected from 107 of 113 (94.7%) primary hospitals due to inaccessibility of some primary hospitals. The minimum national standard requirement of a level one neonatal intensive care unit for infrastructure was met by 63% (68/107) and 44% (47/107) had fulfilled the requirements for kangaroo mother care units. The average number of neonatal intensive care unit trained nurses per primary hospital was 2.6, 0.8 for general practitioners and 2.9 support staff; all of which is less than the minimum recommended national standard. The minimum national requirement for medical equipment and renewables for primary hospital level was fulfilled by 24% (26/107) of the hospitals, 65% (70/107) for essential laboratory tests, and 87% (93/107) for clinical services and procedures. The average number of admissions during the six months prior to the data collection was 87.2 sick newborns per facility with a 'discharged improved' rate of 71.5%, referral out rate of 18.4% and level one neonatal intensive care unit death rate of 6.6%. The remaining newborns had either left against medical advice or were still undergoing treatment during data collection.
The overall readiness of primary hospitals to deliver neonatal intensive care services in terms of infrastructure, human resource, medical equipment, and laboratory tests was found to be low. There is a need to fill gaps in infrastructure, medical equipment, renewables, human resource, laboratory reagents, drugs and other supplies of neonatal intensive care units of primary hospitals to garner better quality of service delivery.
多年来，埃塞俄比亚的新生儿死亡率并没有太大的改善。鉴于此，该国已经引入了一些干预措施，如利用新生儿角落和新生儿重症监护病房来避免可预防的新生儿死亡。本研究旨在评估初级医院提供新生儿重症监护服务的准备情况。
采用基于卫生机构的横断面研究设计，使用从国家文件改编的格式，同时使用前瞻性和回顾性技术收集数据。使用 SPSS 版本 25 输入和分析数据，使用描述性统计。
由于一些初级医院无法进入，因此从 113 家初级医院中收集了 107 家（94.7%）的数据。基础设施方面，一级新生儿重症监护单位的最低国家标准要求有 63%（68/107）达标，44%（47/107）符合袋鼠式护理单位的要求。每所初级医院平均有 2.6 名接受过新生儿重症监护培训的护士、0.8 名全科医生和 2.9 名支持人员；所有这些都低于最低建议的国家标准。有 24%（26/107）的医院达到了初级医院一级的医疗设备和可再生资源的最低国家标准要求，65%（70/107）的医院能够进行基本的实验室检测，87%（93/107）的医院能够提供临床服务和程序。在数据收集前的六个月内，每家医院平均收治 87.2 名患病新生儿，其中“改善出院”率为 71.5%，转诊率为 18.4%，一级新生儿重症监护病房死亡率为 6.6%。其余新生儿要么未经医嘱就出院，要么在数据收集期间仍在接受治疗。
就基础设施、人力资源、医疗设备和实验室检测而言，初级医院提供新生儿重症监护服务的整体准备情况较差。需要填补初级医院新生儿重症监护单位在基础设施、医疗设备、可再生资源、人力资源、实验室试剂、药品和其他供应方面的差距，以提高服务质量。
