Barriers and Facilitators of Community Based Service Utilization for Newborn Possible Serious Bacterial Infection Management in North Shoa, Oromia, Ethiopia

Abstract

Background: Worldwide, possible serious bacterial infection causes about 600,000 neonatal deaths per year. Community based management of newborn possible serious bacterial infection when referral is not possible has been on implementation. Studies showed gaps on its service utilization but studies addressing its barriers were not accessed. Objective: To explore barriers and facilitators of community-based service utilization for newborn possible serious bacterial infection management. Methods: A descriptive qualitative study was conducted from March 11– April 7, 2019 in Debre Libanos District, Ethiopia. Study participants were recruited purposively from six kebeles; women‟s delivered within the last two months were the primary study participants. Twelve in-depth interview and three focused group discussions were conducted; data was audio-recorded, transcribed verbatim and translated, and analyzed using inductive thematic analysis on atlas ti.7.1. Findings: This study explored facilitators like availability of HEWs trained on communitybased newborn care [CBNC], health workers trained on Integrated Management of Newborn and Childhood Illness [IMNCI], medical supplies and job aids,and performance review meetings; and barriers like communities perception on newborn illnesses, belief of traditional medicine, health care seeking decision making, socio-cultural and religious beliefs, lack of awareness onservice availability, lack of program ownership and sustainability, unavailability of CBNC trained health worker, weak health center and health post linkage, shortage of HEWs, residency of HEWs, closure of health posts on working hours, poor HEWs commitment and non-functionality of one to five and health developmental army [HDA] were explored. Conclusions: This study found that community based management of newborn PSBI was discontinued due to barriers explored at different settings. This has big implication in that it might not be possible to reduce newborn death with this community-based program in this study setting. Therefore, attention should be given for the program to foster its implementation, creating demand and developing health seeking behavior of the community for newborn illnesses