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Evidence‐based training and mentorship combined with enhanced outcomes surveillance to address the leading causes of neonatal mortality at the district hospital level in G hana

2014; Wiley; Volume: 19; Issue: 4 Linguagem: Inglês

10.1111/tmi.12270

1365-3156

Mary N. A. Brantuo, Elizabeth Cristofalo, Mira Meheš, Juliana Ameh, Nana Okai Brako, Frederick Boahene, Stella Barniie Adjei, Ernest Opoku, Harriet Banda, Yu Tian Wang, Abdulai A. Forgor, Damien Punguire, Kennedy Brightson, Cynthia Akorfa Sottie, Seth Owusu‐Agyei, John E. Williams, Abubakari Sulemana, Abraham Oduro, Margaret Gyampong, Doris Sarpong, Edith Andrews, Martha Gyansa‐Lutterodt, Abraham Hodgson, Cynthia Gyamfi Bannerman, Fizan Abdullah,

Maternal and Neonatal Healthcare

Abstract Objective To evaluate the impact of a district hospital intervention focused on enhancing healthcare provider capacity to address leading causes of neonatal death: birth asphyxia, infection and prematurity. Methods The n eonatal q uality i mprovement initiative was launched at two intervention referral district hospitals in G hana. Local H ealth and D emographic S urveillance S ystems were enlisted to enhance recording of neonatal and infant deaths in the community and at the facility. After baseline site assessments, a team of local paediatric experts conducted three clinical trainings on‐site at each intervention hospital. Assessments were conducted to evaluate participant knowledge before and after participation in training modules. Monthly mentorship visits provided additional training to support the adoption of essential early neonatal care practices. Results In the first year of implementation, the initiative provided focused clinical training to 278 participants. A comparison of pre‐ and post‐training test results demonstrates significant improvement in provider knowledge (73% vs . 89% correct, P < 0.001), with even greater improvement among trainees receiving recurrent refresher training (86% vs . 94% correct, P < 0.001). Participant feedback following training revealed enthusiasm about the programme and improved confidence. Conclusions Locally led initiatives that invest directly in healthcare provider education and health systems strengthening represent a promising avenue for reducing neonatal morbidity and mortality. The NQI initiative demonstrates the positive impact of a district hospital intervention that combines on‐site training, mentorship and enhanced demographic surveillance.