Essential newborn care practices for healthy newborns at a district hospital in Pemba, Tanzania: a cross-sectional observational study utilizing video recordings

Christina Nadia Stensgaard*, Christine Manich Bech, Charlotte Holm-Hansen, Tine Bruhn Skytte, Said Mohammed Ali, Ulfat Amour Mohd, Jesper Kjærgaard, Gorm Greisen, Anja Poulsen, Stine Lund

*Corresponding author for this work
3 Citations (Scopus)

Abstract

BACKGROUND: High-quality essential newborn care (ENC) can improve newborn health and reduce preventable newborn mortality. The World Health Organization recommends specific ENC interventions. Video recordings have potential as a tool for assessment of clinical care also in low and middle-income countries.

OBJECTIVE: To use video observations of healthy newborns to describe ENC practices in a low-income setting and compare actual clinical practice with WHO recommendations.

METHOD: This is a cross-sectional observational study. Video records of neonatal interventions to 324 healthy newborns were assessed. They were obtained at baseline of a pre-post intervention study during a 10-week study period in Pemba, Tanzania. Data also included postnatal structured questionnaires. Eight ENC interventions and quality indicators were defined as per the WHO recommendations. Descriptive statistics were used to summarize ENC practices and maternal and neonatal characteristics.

RESULTS: None of the newborns received all eight recommended ENC interventions. The median duration of separation from the mother was 25 minutes and 15 seconds (ranging from 22 seconds to 3 hours and 36 minutes), 51% of the newborns received proper thermal care during the separation. Twenty-one percent had sufficient umbilical cord care, 8% were stimulated for breathing, 69% were observed at least once by healthcare staff and 9% did undergo suctioning. None of the newborns received antibiotic ointments or vitamin K.

CONCLUSION: Video recording of healthy newborns was feasible. The study identified omission of key ENC practices including proper thermal care, skin-to-skin contact and establishment of breastfeeding within the first hour of life, vitamin K administration as well as application of unnecessary practices such as excessive suctioning of breathing newborns.

Original languageEnglish
Article number2067398
JournalGlobal Health Action
Volume15
Issue number1
Number of pages11
ISSN1654-9716
DOIs
Publication statusPublished - 31 Dec 2022

Keywords

  • ENC compliance
  • ENC interventions
  • Hawthorne effect
  • low resource setting
  • video observations
  • WHO recommendations

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