Process Evaluation of Community Based Newborn Care Program in Geze Gofa District, Gamo Gofa Zone, Southern Ethiopia

Abstract

Background: Community Based Newborn Care program is a comprehensive strategy designed to improve the health of newborns at community level through interventions during pregnancy, at and soon after birth, and in the postnatal period by Health Extension Workers. Objectives: To evaluate the process of Community Based Newborn Care services implementation in Geze Gofa district, Gamo Gofa zone, Southern Ethiopia 2016/2017. Methods: Case study design with mixed methods was employed to evaluate the process of Community Based Newborn Care program implementation from March 1 to 31, 2017. The process was measured using availability, compliance and acceptability/satisfaction dimensions with 36 indicators. A total of 321 mothers who gave birth from September 1, 2016 to February 30, 2017 were interviewed home to home. Moreover 27 direct observations, six-month retrospective document review, and 14 key informants’ interview with manager and health workers were conducted purposefully. Quantitative data were entered in to Epi Data version 3.1 and exported to SPSS version 20 for analysis. Qualitative data were transcribed, translated, coded and analyzed in themes. Variables with p-value < 0.25 in bivariate logistic regression were candidate for multiple logistic regression. P-value < 0.05 and confidence interval were used to declare association. The overall process of program implementation was determined based on pre-set criteria of judgmental. Findings were presented using descriptions, tables and graphs. Result: The overall level of process of Community Based Newborn Care program implementation according to the judgmental parameter was 72.67 percent. The satisfaction of mothers was 75.05 percent. Resources availability was 81 percent and compliance was 68 percent. The compliance and satisfaction dimension were the area that face many constraints. Very Sever Diseases are not treated congruently to the national guideline and identification of neonatal sepsis cases was low. Mothers satisfaction affected by occupational and wealth status. Conclusion: The process of CBNC program was good. It can achieve more by availing drugs and medical supplies; vitamin K, chlorohexidine ointment, gloves, cotton and resuscitation bags. Moreover, regular supportive supervision and follow up is better for program improvement.