Quality of immediate newborn care at jimma university medical center, jimma, novenber, 2018

Abstract

Background: Immediate newborn period is a period with great vulnerability that deserves inordinate attention. Quality of care at this critical period is a global priority due to the fact that quality health care provision at the time of birth is a cost effective intervention to decrease neonatal mortality, which is very high in developing countries particularly in Sub Saharan Africa. However little is known about the overall quality of immediate newborn care provided in the health facilities found in Sub Saharan Africa, particularly in Ethiopia while no study addressed users’ perspective on the area. Objective: To assess quality of immediate newborn care in University Medical Center. Methods: An institution based cross-sectional study design using quantitative method supplemented with qualitative data was conducted in JUMC from March 1 - 30, 2018. The sample size for quantitative study was 384 mothers who gave birth in the hospital, 99 health care providers working in obstetric unit, 14 practice observations and 14 In-depth interviews were conducted for qualitative study. Quantitative data was entered into Epi-data version 4.0.2.101 and exported to SPSS version 23, for analysis. Principal component analysis was used to assess quality of INC (Immediate newborn Care) and descriptive analysis was conducted. Binary and multiple logistic regression analysis was done to identify factors associated with maternal satisfaction on INC provided and Statistical significance was declared at p- value < 0.05. Adjusted odds ratios were used to see the strength of association with 95% CI. Qualitative data was analyzed thematically by manually. Quantitative data results were triangulated with qualitative. Result: The overall quality of INC provided in the hospital was 61.9%. Accordingly, 55.6% good care provision setup, 65.7% good knowledge and practice self-report and 73.7% of maternal satisfaction are reported on INC provided at the institution. Moreover, one-fourth (25%) of the health care providers reported availability of medical supplies, and few (19.2%) received Essential newborn care training. Health care knowledge and practice reports are also less than international standard requirement, and missed INC components reported by qualitative finding. Furthermore, the overall maternal satisfaction was about 73%. Hence, two of maternal attributes shows strong association with their satisfaction; mothers who reported the infrastructure as good were 3.6 times more likely to be satisfied compared to those who reported as poor with p-value of 0.01(AOR=3.596, 95% CI= (1.36, 9.54)), and those mothers who rated the quality of INC provided in the hospital as good were nearly five times more likely to be satisfied when compared to those who rated as poor with p- value of <0.001 (AOR= 4.95, 95% CI= (2.91, 8.43)). Conclusion and recommendation: the overall quality of INC was poor, and maternal satisfaction status on INC provided was also less-than WHO recommendation. The hospital infrastructure and INC rated by mothers had strong association with maternal satisfaction. More attention should also be given to the overall INC quality and its sub-components that helps to increases chance of neonatal survival and maternal satisfaction