Resource availability and barriers to delivering quality care for newborns in hospitals in the southern region of Malawi: A multisite observational study.

Autor:	Gondwe MJ; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.; Behaviour and Health Group, Malawi Liverpool Wellcome Trust- Clinical Research Programme, Blantyre, Malawi., Desmond N; Behaviour and Health Group, Malawi Liverpool Wellcome Trust- Clinical Research Programme, Blantyre, Malawi.; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Aminu M; Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom., Allen S; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Jazyk:	angličtina
Zdroj:	PLOS global public health [PLOS Glob Public Health] 2022 Dec 05; Vol. 2 (12), pp. e0001333. Date of Electronic Publication: 2022 Dec 05 (Print Publication: 2022).
DOI:	10.1371/journal.pgph.0001333
Abstrakt:	Facility-based births have increased in low and middle-income countries, but babies still die due to poor care. Improving care leads to better newborn outcomes. However, data are lacking on how well facilities are prepared to support. We assessed the availability of human and material resources and barriers to delivering quality care for newborns and barriers to delivering quality care for newborns. We adapted the WHO Service Availability and Readiness Assessment tool to evaluate the resources for delivery and newborn care and barriers to delivering care, in a survey of seven hospitals in southern Malawi between January and February 2020. Data entered into a Microsoft Access database was exported to IBM SPSS 26 and Microsoft Excel for analysis. All hospitals had nursery wards with at least one staff available 24 hours, a clinical officer trained in paediatrics, at least one ambulance, intravenous cannulae, foetal scopes, weighing scales, aminophylline tablets and some basic laboratory tests. However, resources lacking some or all of the time included anticonvulsants, antibiotics, vitamin K, 50% dextrose, oxytocin, basic supplies such as cord clamps and nasal gastric tubes, laboratory tests such as bilirubin and blood culture and newborn clinical management guidelines. Staff reported that the main barriers to providing high-quality care were erratic supplies of power and water, inadequacies in the number of beds/cots, ambulances, drugs and supplies, essential laboratory tests, absence of newborn clinical protocols, and inadequate staff, including paediatric specialists, in-service training, and support from the management team. In hospitals in Malawi, quality care for deliveries and newborns was compromised by inadequacies in many human and material resources. Addressing these deficiencies would be expected to lead to better newborn outcomes. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2022 Gondwe et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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