Preparedness for essential newborn care: a multicentre cross-sectional
study conducted in five districts of India
Abstract
Objective To assess the preparedness of public health care facilities to
provide essential newborn care across India Design Mixed methods study
analysing the collected cross sectional observational data across five
districts of India. Setting India, across districts of Thiruvallur,
Cuttack, Allahabad, Vadodara and Jaipur Sample 56 healthcare facilities
comprising of Medical colleges, District/Sub-district hospitals, and
Community Health Centres/First Referral Units and Primary Healthcare
units. 1479 women undergoing vaginal delivery and qualitative data on
attitude and barriers faced while following mandated guidelines of
essential newborn care were collected from 125 healthcare providers.
Method Descriptive analysis for the quantitative data and inductive and
deductive analysis for the qualitative data Main outcome measure
Preparedness of different facilities was considered as a composite of
four dimensions- Clean delivery, Clean cord care, Optimal thermal care
and Early exclusive breastfeeding. Results Provision of hygienic
delivery (50.8%) and optimal thermal care (26.1%) was observed to be
highest among the women availing services in Medical Colleges and clean
cord care was highest in PHCs (52.9%). Nearly 77% of cases in
CHCs/FRUs experienced exclusive breast feeding. Pre-lacteal feeding,
immediate cord clamping and application of traditional dressing on cord
stump were prevalent undesirable neonatal care practices. Conclusion
Deviations from the mandated essential newborn care protocols by a
noteworthy proportion of healthcare professionals including at teaching
Medical colleges was observed. Unavailability of sufficient medical
supplies for safe and hygienic newborn care in addition to the need for
training for essential newborn care was observed.