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Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India
BACKGROUND: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576775/ https://www.ncbi.nlm.nih.gov/pubmed/33087124 http://dx.doi.org/10.1186/s12913-020-05805-2 |
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author | Mungai, Isaac Gikandi Baghel, Sumit Singh Soni, Shuchi Vagela, Shailja Sharma, Megha Diwan, Vishal Tamhankar, Ashok J. Lundborg, Cecilia Stålsby Pathak, Ashish |
author_facet | Mungai, Isaac Gikandi Baghel, Sumit Singh Soni, Shuchi Vagela, Shailja Sharma, Megha Diwan, Vishal Tamhankar, Ashok J. Lundborg, Cecilia Stålsby Pathak, Ashish |
author_sort | Mungai, Isaac Gikandi |
collection | PubMed |
description | BACKGROUND: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. METHODS: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. RESULTS: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75(th) and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90(th)). CONCLUSIONS: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services. |
format | Online Article Text |
id | pubmed-7576775 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-75767752020-10-21 Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India Mungai, Isaac Gikandi Baghel, Sumit Singh Soni, Shuchi Vagela, Shailja Sharma, Megha Diwan, Vishal Tamhankar, Ashok J. Lundborg, Cecilia Stålsby Pathak, Ashish BMC Health Serv Res Research Article BACKGROUND: More than a quarter of global neonatal deaths are reported from India, and a large proportion of these deaths are preventable. However, in the absence of robust public health care systems in several states in India, informal health care providers (IHCPs) with no formal medical education are the first contact service providers. The aim of this study was to assess the knowledge of IHCPs in basic evidence-based practices in neonatal care in Ujjain district and investigated factors associated with differences in levels of knowledge. METHODS: A cross-sectional survey was conducted using a questionnaire with multiple-choice questions covering the basic elements of neonatal care. The total score of the IHCPs was calculated. Multivariate quantile regression model was used to look for association of IHCPs knowledge score with: the practitioners’ age, years of experience, number of patients treated per day, and whether they attended children in their practice. RESULTS: Of the 945 IHCPs approached, 830 (88%) participated in the study. The mean ± SD score achieved was 22.3 ± 7.7, with a median score of 21 out of maximum score of 48. Although IHCPs could identify key tenets of enhancing survival chances of neonates, they scored low on the specifics of cord care, breastfeeding, vitamin K use to prevent neonatal hemorrhage, and identification and care of low-birth-weight babies. The practitioners particularly lacked knowledge about neonatal resuscitation, and only a small proportion reported following up on immunizations. Results of quantile regression analysis showed that more than 5 years of practice experience and treating more than 20 patients per day had a statistically significant positive association with the knowledge score at higher quantiles (q75(th) and q90th) only. IHCPs treating children had significantly better scores across quantiles accept at the highest quantile (90(th)). CONCLUSIONS: The present study highlighted that know-do gap exists in evidence-based practices for all key areas of neonatal care tested among the IHCPs. The study provides the evidence that some IHCPs do possess knowledge in basic evidence-based practices in neonatal care, which could be built upon by future educational interventions. Targeting IHCPs can be an innovative way to reach a large rural population in the study setting and to improve neonatal care services. BioMed Central 2020-10-21 /pmc/articles/PMC7576775/ /pubmed/33087124 http://dx.doi.org/10.1186/s12913-020-05805-2 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Mungai, Isaac Gikandi Baghel, Sumit Singh Soni, Shuchi Vagela, Shailja Sharma, Megha Diwan, Vishal Tamhankar, Ashok J. Lundborg, Cecilia Stålsby Pathak, Ashish Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India |
title | Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India |
title_full | Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India |
title_fullStr | Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India |
title_full_unstemmed | Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India |
title_short | Identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from Ujjain, India |
title_sort | identifying the know-do gap in evidence-based neonatal care practices among informal health care providers—a cross-sectional study from ujjain, india |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576775/ https://www.ncbi.nlm.nih.gov/pubmed/33087124 http://dx.doi.org/10.1186/s12913-020-05805-2 |
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