Portal de Periódicos da CAPES

Health facility assessment of small and sick newborn care in low- and middle-income countries: systematic tool development and operationalisation with NEST360 and UNICEF

2024; BioMed Central; Volume: 23; Issue: S2 Linguagem: Inglês

10.1186/s12887-023-04495-z

1471-2431

Rebecca E. Penzias, Christine Bohne, Samuel Ngwala, Evelyn Zimba, Norman Lufesi, Ekran Rashid, Edith Gicheha, Opeyemi Odedere, Olabisi Dosunmu, Robert Tillya, Josephine Shabani, James Cross, Sara Liaghati-Mobarhan, Msandeni Chiume, George Banda, Alfred Chalira, John Wainaina, David Gathara, Grace Irimu, Steve Adudans, Femi James, Olukemi O. Tongo, Chinyere Ezeaka, Georgina Msemo, Nahya Salim, Louise T. Day, Timothy Powell‐Jackson, Jaya Chandna, Maureen Daisy Majamanda, Elizabeth Molyneux, Maria Odén, Rebecca Richards–Kortum, Eric O. Ohuma, Chris Paton, Tedbabe Hailegabriel, Gagan Gupta, Joy E. Lawn, Aba Asibon, Megan Heenan, Ivan Mambule, Kara Palamountain, Martha Mkony, Kondwani Kawaza, Jenny Werdenberg, Victor Tumukunde, Sue Prullage, Dickson Otiangala, Elizabeth Asma, Cally J Tann, Danica Kumara, Melissa M. Medvedev, Simeon Yosefe, Mike English, Honorati Masanja, Bertha Kaudzu, Angeline Chiotcha, Harriet Ruysen, Oona M. R. Campbell, Gina Murphy, Samantha Herrera, Natasha Rhoda, Lily Kak, Vincent Ochieng, Sam Wachira, Catherine Okunola, Olabanjo Okunlola Ogunsola, Adewole, Donat Shamba, Ahazi Manjonda, Irabi Kassim, Giorgia Gon, Grace Tahuna Soko, Emmie Mbale, Mwanamvua Boga, Charles C. Osuagwu, Mary Ngugi, Harold Chimphepo, Esan Bukola, Valentino Mvanga, Linda Vugutsa Kagasi, Josephat Mutakyamilwa, Maureen Valle, Carolyne Mwangi, Bridget Wesonga, Audrey Chepkemoi, Joseph Chabi, Mohammed Sheikh, Robert Ngunjiri, Beth Maina, Mary Waiyego, Enock Sigilai, Grace Wasike, Isaac Cheptiany, Josephine Aritho, Josephine Bariu, Lucy Kinyua, Lydia Karimurio, Martin Matingi, Fred Were, Wanjiku Manguyu, Jenny Carns, Caroline Noxon, Esalee Andrade, Taylor Boles, Brady Hunt, Akshaya Santhanaraj, Madeleine Tadros, Meghan Bruce Kumar, Christina Mchoma, Joseph Bilitinyu, Pius Chalamanda, Mirriam Dzinkambani, Ruth Mhango, Fanny Stevens, Joseph Mulungu, Blessings Makhumula, Loveness Makota Banda, Charles Banda, Brian Chumbi, Chifundo Banda, Evelyn Chimombo, Nicodemus Nyasulu, Innocent Ndau, Pilirani Kumwembe, Edna Kerubo, Nyphry Ambuso, Kevin Koech, Noel Waithaka, Calet Wakhungu, Steven Otieno, Felix Bahati, Josphine Ayaga, Jedida Obure, Nellius Nderitu, Violet Mtambo, George Mkude, Mustapha Miraji, Caroline Shayo, Camilius Nambombi, Christopher Cyrilo, Temilade Aderounmu, Akingbehin Wakeel Wale, Odeleye Victoria Yemisi, Akinola Amudalat Dupe, Samuel Awolowo, Ojelabi Oluwaseun, John Ajiwohwodoma Ovuoraye, Balogun Adeleke Mujaid, Adedoyin Fetuga, Juilana Okanlawon, Flora Awosika, Awotayo Olasupo Michael, Olumide Abiodun,

Maternal and Neonatal Healthcare

Abstract Background Each year an estimated 2.3 million newborns die in the first 28 days of life. Most of these deaths are preventable, and high-quality neonatal care is fundamental for surviving and thriving. Service readiness is used to assess the capacity of hospitals to provide care, but current health facility assessment (HFA) tools do not fully evaluate inpatient small and sick newborn care (SSNC). Methods Health systems ingredients for SSNC were identified from international guidelines, notably World Health Organization (WHO), and other standards for SSNC. Existing global and national service readiness tools were identified and mapped against this ingredients list. A novel HFA tool was co-designed according to a priori considerations determined by policymakers from four African governments, including that the HFA be completed in one day and assess readiness across the health system. The tool was reviewed by > 150 global experts, and refined and operationalised in 64 hospitals in Kenya, Malawi, Nigeria, and Tanzania between September 2019 and March 2021. Results Eight hundred and sixty-six key health systems ingredients for service readiness for inpatient SSNC were identified and mapped against four global and eight national tools measuring SSNC service readiness. Tools revealed major content gaps particularly for devices and consumables, care guidelines, and facility infrastructure, with a mean of 13.2% ( n = 866, range 2.2–34.4%) of ingredients included. Two tools covered 32.7% and 34.4% ( n = 866) of ingredients and were used as inputs for the new HFA tool, which included ten modules organised by adapted WHO health system building blocks, including: infrastructure, pharmacy and laboratory, medical devices and supplies, biomedical technician workshop, human resources, information systems, leadership and governance, family-centred care, and infection prevention and control. This HFA tool can be conducted at a hospital by seven assessors in one day and has been used in 64 hospitals in Kenya, Malawi, Nigeria, and Tanzania. Conclusion This HFA tool is available open-access to adapt for use to comprehensively measure service readiness for level-2 SSNC, including respiratory support. The resulting facility-level data enable comparable tracking for Every Newborn Action Plan coverage target four within and between countries, identifying facility and national-level health systems gaps for action.