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Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya

Possible severe bacterial infections (PSBI) is one of the three leading causes of newborn and young infant mortality globally that can be prevented by timely diagnosis and treatment using suitable antibiotics. High impact interventions such as use of out-patient injectable gentamicin and dispersible...

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Autores principales: Gitaka, Jesse, Mbugua, Samuel, Mwaura, Peter, Gatungu, Daniel, Githanga, David, Ndwiga, Charity, Abuya, Timothy, K’Oduol, Kezia, Liambila, Wilson, Were, Fred
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022333/
https://www.ncbi.nlm.nih.gov/pubmed/36962529
http://dx.doi.org/10.1371/journal.pgph.0000183
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author Gitaka, Jesse
Mbugua, Samuel
Mwaura, Peter
Gatungu, Daniel
Githanga, David
Ndwiga, Charity
Abuya, Timothy
K’Oduol, Kezia
Liambila, Wilson
Were, Fred
author_facet Gitaka, Jesse
Mbugua, Samuel
Mwaura, Peter
Gatungu, Daniel
Githanga, David
Ndwiga, Charity
Abuya, Timothy
K’Oduol, Kezia
Liambila, Wilson
Were, Fred
author_sort Gitaka, Jesse
collection PubMed
description Possible severe bacterial infections (PSBI) is one of the three leading causes of newborn and young infant mortality globally that can be prevented by timely diagnosis and treatment using suitable antibiotics. High impact interventions such as use of out-patient injectable gentamicin and dispersible Amoxicillin with community-based follow up have been shown to reduce mortality in clinical trials. The objective of this study was to assess the health systems’ preparedness and organizational gaps that may impact execution in providing care for newborns and sick young infants. This formative research study was embedded within a three-year implementation research project in 4 Counties in Kenya. The indicators were based on facility audits for existing capacity to care for newborns and young infants as well as County organizational capacity assessment. The organizational capacity assessment domains were derived from the World Health Organization’s Health Systems Building blocks for health service delivery. The scores were computed by adding average scores in each domain and calculated against the total possible scores to generate a percentage outcome. Statistical analyses were descriptive with adjustment for clustering of data. Overall, the Counties have inadequate organizational capacity for management of sick young infants with Organizational Capacity Index scores of between 61–64%. Among the domains, the highest score was in Health Management Information System and service delivery. The lowest scores were in monitoring and evaluation (M&E). Counties scored relatively low scores in human resources for health and health products and commodities with one scoring poorly for both areas while the rest scored average performance. The four counties revealed varying levels of organizational capacity deficit to effectively manage sick young infants. The key underlying issues for the below par performance include poor coordination, low funding, inadequate supportive supervision, and M&E to enable data utilisation for quality improvement. It was evident that newborn and young infant health services suffer from inadequate infrastructure, equipment, staffing, and coordination. As Kenya, continuously rolls out the guidelines on management of sick young infants, there is need to focus attention to these challenges to enhance sustainable adoption and reduction of young infant morbidity and mortality.
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spelling pubmed-100223332023-03-17 Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya Gitaka, Jesse Mbugua, Samuel Mwaura, Peter Gatungu, Daniel Githanga, David Ndwiga, Charity Abuya, Timothy K’Oduol, Kezia Liambila, Wilson Were, Fred PLOS Glob Public Health Research Article Possible severe bacterial infections (PSBI) is one of the three leading causes of newborn and young infant mortality globally that can be prevented by timely diagnosis and treatment using suitable antibiotics. High impact interventions such as use of out-patient injectable gentamicin and dispersible Amoxicillin with community-based follow up have been shown to reduce mortality in clinical trials. The objective of this study was to assess the health systems’ preparedness and organizational gaps that may impact execution in providing care for newborns and sick young infants. This formative research study was embedded within a three-year implementation research project in 4 Counties in Kenya. The indicators were based on facility audits for existing capacity to care for newborns and young infants as well as County organizational capacity assessment. The organizational capacity assessment domains were derived from the World Health Organization’s Health Systems Building blocks for health service delivery. The scores were computed by adding average scores in each domain and calculated against the total possible scores to generate a percentage outcome. Statistical analyses were descriptive with adjustment for clustering of data. Overall, the Counties have inadequate organizational capacity for management of sick young infants with Organizational Capacity Index scores of between 61–64%. Among the domains, the highest score was in Health Management Information System and service delivery. The lowest scores were in monitoring and evaluation (M&E). Counties scored relatively low scores in human resources for health and health products and commodities with one scoring poorly for both areas while the rest scored average performance. The four counties revealed varying levels of organizational capacity deficit to effectively manage sick young infants. The key underlying issues for the below par performance include poor coordination, low funding, inadequate supportive supervision, and M&E to enable data utilisation for quality improvement. It was evident that newborn and young infant health services suffer from inadequate infrastructure, equipment, staffing, and coordination. As Kenya, continuously rolls out the guidelines on management of sick young infants, there is need to focus attention to these challenges to enhance sustainable adoption and reduction of young infant morbidity and mortality. Public Library of Science 2022-10-20 /pmc/articles/PMC10022333/ /pubmed/36962529 http://dx.doi.org/10.1371/journal.pgph.0000183 Text en © 2022 Gitaka et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Gitaka, Jesse
Mbugua, Samuel
Mwaura, Peter
Gatungu, Daniel
Githanga, David
Ndwiga, Charity
Abuya, Timothy
K’Oduol, Kezia
Liambila, Wilson
Were, Fred
Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya
title Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya
title_full Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya
title_fullStr Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya
title_full_unstemmed Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya
title_short Devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in Kenya
title_sort devolved health system capacity in the provision of care for sick newborns and young infants in four counties serving vulnerable populations in kenya
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10022333/
https://www.ncbi.nlm.nih.gov/pubmed/36962529
http://dx.doi.org/10.1371/journal.pgph.0000183
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