Cargando…
Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study
INTRODUCTION: Pakistan is facing a challenging situation in terms of high newborn mortality rate. Securing pregnancy and delivery care may not bring a substantial reduction in neonatal mortality, unless coupled with the provision of quality inpatient care for small and sick newborns and young infant...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800326/ https://www.ncbi.nlm.nih.gov/pubmed/35093035 http://dx.doi.org/10.1186/s12887-022-03108-5 |
_version_ | 1784642236419407872 |
---|---|
author | Pradhan, Nousheen Akber Ali, Sumera Aziz Roujani, Sana Ali, Ammarah Hussain, Syed Shujaat Rizwan, Samia Ariff, Shabina Saleem, Sarah Siddiqi, Sameen |
author_facet | Pradhan, Nousheen Akber Ali, Sumera Aziz Roujani, Sana Ali, Ammarah Hussain, Syed Shujaat Rizwan, Samia Ariff, Shabina Saleem, Sarah Siddiqi, Sameen |
author_sort | Pradhan, Nousheen Akber |
collection | PubMed |
description | INTRODUCTION: Pakistan is facing a challenging situation in terms of high newborn mortality rate. Securing pregnancy and delivery care may not bring a substantial reduction in neonatal mortality, unless coupled with the provision of quality inpatient care for small and sick newborns and young infants (NYIs). We undertook this study to assess the availability and quality of newborn care services provided and the readiness of inpatient care for NYIs in Pakistan. METHODS: We conducted a cross-sectional study across Pakistan from February to June 2019, using a purposive sample of 61% (23) of the 38 sick newborn care units at public sector health care facilities providing inpatient care for small and sick NYIs. We interviewed facility managers and health care providers by using structured questionnaires. We observed facility infrastructure and relevant metrics related to the quality of inpatient care such as types of infant care units and essential equipment, drugs, staffing cadre and facility management practices, quality assurance activities, essential services for small and sick NYI care, discharge planning, and support, quality of NYIs care record, and health information system. RESULTS: Of the 23 facilities assessed, 83% had newborn intensive care units (NICUs), 74% reported Special Care Units (SCUs), and only 44% had Kangaroo Mother Care (KMC) Units. All facilities had at least one paediatrician, 13% had neonatologists and neonatal surgeons each. Around 61 and 13% of the facilities had staff trained in neonatal resuscitation and parental counseling, respectively. About 35% of the facilities monitored nosocomial infection rates, with management and interdisciplinary team meetings reported from 17 and 30% of the facilities respectively preceding the survey. Basic interventions for NYIs were available in 43% of the facilities, only 35% of facilities had system in place to monitor nosocomial infections for NYI care. Most (73%) of reviewed records of NYIs at 1–2 days had information on the birth weight, temperature recording (52%), while only a quarter (25%) of the observed records documented danger signs. Mechanism to support discharge care by having linkages with community workers was present in 13% of the facilities, while only 35% of the facilities have strategies to promote adherence after discharge. Majority (78%) of facilities reported monitoring any newborn/ neonatal care indicators, while none of the sub-units within facilities had consolidated information on stillbirths and neonatal deaths. CONCLUSION: The study has demonstrated important gaps in the quality of small and sick NYI inpatient care in the country. To avert neonatal mortality in the country, provincial and district governments have to take actions in improving the quality of inpatient care. |
format | Online Article Text |
id | pubmed-8800326 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88003262022-02-02 Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study Pradhan, Nousheen Akber Ali, Sumera Aziz Roujani, Sana Ali, Ammarah Hussain, Syed Shujaat Rizwan, Samia Ariff, Shabina Saleem, Sarah Siddiqi, Sameen BMC Pediatr Research INTRODUCTION: Pakistan is facing a challenging situation in terms of high newborn mortality rate. Securing pregnancy and delivery care may not bring a substantial reduction in neonatal mortality, unless coupled with the provision of quality inpatient care for small and sick newborns and young infants (NYIs). We undertook this study to assess the availability and quality of newborn care services provided and the readiness of inpatient care for NYIs in Pakistan. METHODS: We conducted a cross-sectional study across Pakistan from February to June 2019, using a purposive sample of 61% (23) of the 38 sick newborn care units at public sector health care facilities providing inpatient care for small and sick NYIs. We interviewed facility managers and health care providers by using structured questionnaires. We observed facility infrastructure and relevant metrics related to the quality of inpatient care such as types of infant care units and essential equipment, drugs, staffing cadre and facility management practices, quality assurance activities, essential services for small and sick NYI care, discharge planning, and support, quality of NYIs care record, and health information system. RESULTS: Of the 23 facilities assessed, 83% had newborn intensive care units (NICUs), 74% reported Special Care Units (SCUs), and only 44% had Kangaroo Mother Care (KMC) Units. All facilities had at least one paediatrician, 13% had neonatologists and neonatal surgeons each. Around 61 and 13% of the facilities had staff trained in neonatal resuscitation and parental counseling, respectively. About 35% of the facilities monitored nosocomial infection rates, with management and interdisciplinary team meetings reported from 17 and 30% of the facilities respectively preceding the survey. Basic interventions for NYIs were available in 43% of the facilities, only 35% of facilities had system in place to monitor nosocomial infections for NYI care. Most (73%) of reviewed records of NYIs at 1–2 days had information on the birth weight, temperature recording (52%), while only a quarter (25%) of the observed records documented danger signs. Mechanism to support discharge care by having linkages with community workers was present in 13% of the facilities, while only 35% of the facilities have strategies to promote adherence after discharge. Majority (78%) of facilities reported monitoring any newborn/ neonatal care indicators, while none of the sub-units within facilities had consolidated information on stillbirths and neonatal deaths. CONCLUSION: The study has demonstrated important gaps in the quality of small and sick NYI inpatient care in the country. To avert neonatal mortality in the country, provincial and district governments have to take actions in improving the quality of inpatient care. BioMed Central 2022-01-29 /pmc/articles/PMC8800326/ /pubmed/35093035 http://dx.doi.org/10.1186/s12887-022-03108-5 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/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/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://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 Pradhan, Nousheen Akber Ali, Sumera Aziz Roujani, Sana Ali, Ammarah Hussain, Syed Shujaat Rizwan, Samia Ariff, Shabina Saleem, Sarah Siddiqi, Sameen Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study |
title | Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study |
title_full | Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study |
title_fullStr | Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study |
title_full_unstemmed | Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study |
title_short | Quality of care assessment for small and sick newborns and young infants in Pakistan: findings from a cross-sectional study |
title_sort | quality of care assessment for small and sick newborns and young infants in pakistan: findings from a cross-sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8800326/ https://www.ncbi.nlm.nih.gov/pubmed/35093035 http://dx.doi.org/10.1186/s12887-022-03108-5 |
work_keys_str_mv | AT pradhannousheenakber qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT alisumeraaziz qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT roujanisana qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT aliammarah qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT hussainsyedshujaat qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT rizwansamia qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT ariffshabina qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT saleemsarah qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy AT siddiqisameen qualityofcareassessmentforsmallandsicknewbornsandyounginfantsinpakistanfindingsfromacrosssectionalstudy |