Quality of newborn care at birth in health facilities in Iganga District, Uganda: Client–provider perspectives

Abstract

Introduction Every year more than four million babies die during first week of life due to inadequate care. This has resulted into an important global call for every newborn to receive quality health care. In Eastern Uganda, 30% of newborn deaths are due to delay in receiving quality care. Objective: To assess quality of newborns care at birth in the health facilities in Iganga district. Methods: Across-sectional study design employing qualitative and quantitative technique for data collection was used. A sample of 341 newborn-mother pairs in 7 facilities was observed by trained research assistants. Standard checklists were used to collect data. Quality of newborn care in health facilities was measured using seven process factors, performed by health workers for mother-baby pairs. Each Yes task formed was scored “1” and No task preformed incorrectly was scored “0”. The mean score were computed by adding the scores obtained for each task performed and divided by the total number of items. These transformed into percentage mean scores Results: Generally, quality of newborn care provided was average given the overall the performance mean score of (64.0%). At subscale level, quality of newborn care was good in regards to initiation of breast- feeding (87.0%), clinical assessments of newborn (78.0%) and infection prevention (71.7%). On the other hand, some of process indicators scored average such as thermoregulation (64.4%), preparations to receive the baby (57.0%), other support and care (56.0%). Quality of newborn care in regards to initiation of breathing was poor given the performance mean score of (44.0%). The structural factor of quality of newborn care was average given the availability mean score of (65.7%). Most of the providers perceived quality as good. Most mothers were satisfied (73.6%) with the quality of newborn care at birth in the health facilities. Conclusions: Quality of newborn care at birth in health facilities in Iganga district was average based on the process factors performed by health workers. The structural inputs for newborn care were predominately average. Health care workers perceived quality of newborn care at birth as good. The mothers were also satisfied with the quality of newborn care at birth in the health facilities