Maternal, Child and Adolescent Health Program, Burnet Institute, Melbourne, Australia.
Nossal Institute for Global Health, School of Population and Global Health, University of Melbourne, Melbourne, Australia.
BMC Pregnancy Childbirth. 2022 Jun 1;22(1):462. doi: 10.1186/s12884-022-04735-7.
Renewed attention and investment is needed to improve the quality of care during the early newborn period to address preventable newborn deaths and stillbirths in Papua New Guinea (PNG). We aimed to assess early newborn care practices and identify opportunities for improvement in one province (East New Britain) in PNG.
A mixed-methods study was undertaken in five rural health facilities in the province using a combination of facility audits, labour observations and qualitative interviews with women and maternity providers. Data collection took place between September 2019 and February 2020. Quantitative data were analysed descriptively, whilst qualitative data were analysed using content analysis. Data were triangulated by data source.
Five facility audits, 30 labour observations (in four of the facilities), and interviews with 13 women and eight health providers were conducted to examine early newborn care practices. We found a perinatal mortality rate of 32.2 perinatal deaths per 1000 total births and several barriers to quality newborn care, including an insufficient workforce, critical infrastructure and utility constraints, and limited availability of essential newborn medicines and equipment. Most newborns received at least one essential newborn care practice in the first hour of life, such as immediate and thorough drying (97%).
We observed high rates of essential newborn care practices including immediate skin-to-skin and delayed cord clamping. We also identified multiple barriers to improving the quality of newborn care in East New Britain, PNG. These findings can inform the development of effective interventions to improve the quality of newborn care. Further, this study demonstrates that multi-faceted programs that include increased investment in the health workforce, education and training, and availability of essential equipment, medicines, and supplies are required to improve newborn outcomes.
需要重新关注和投资，以提高新生儿早期护理的质量，从而解决巴布亚新几内亚（PNG）可预防的新生儿死亡和死产问题。我们旨在评估 PNG 一个省（东新不列颠）的新生儿早期护理实践，并确定改进的机会。
在该省的五个农村卫生机构中进行了一项混合方法研究，结合了设施审计、分娩观察和对妇女和产妇提供者的定性访谈。数据收集于 2019 年 9 月至 2020 年 2 月进行。定量数据进行描述性分析，定性数据采用内容分析进行分析。通过数据源对数据进行三角验证。
共进行了五次设施审计、30 次分娩观察（在其中四个设施中）以及对 13 名妇女和 8 名卫生提供者的访谈，以检查新生儿早期护理实践。我们发现围产期死亡率为每 1000 例总分娩中有 32.2 例围产期死亡，并且存在多种质量新生儿护理障碍，包括劳动力不足、关键基础设施和公用事业限制，以及基本新生儿药物和设备的有限可用性。大多数新生儿在生命的第一个小时内至少接受了一项基本的新生儿护理措施，例如立即和彻底干燥（97%）。
我们观察到许多基本的新生儿护理措施的实施率很高，包括立即进行皮肤接触和延迟脐带结扎。我们还确定了在提高东新不列颠，PNG 新生儿护理质量方面存在多种障碍。这些发现可以为制定有效的干预措施提供信息，以提高新生儿护理质量。此外，这项研究表明，需要多方面的计划，包括增加对卫生劳动力、教育和培训以及基本设备、药物和用品的投资，以改善新生儿的结局。
