Health facility assessment of small and sick newborn care in low- and middle-income countries: systematic tool development and operationalisation with NEST360 and UNICEF
Rattachement africain : gb, Tanzanie, us, Malawi, Kenya, Nigéria, nz. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
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.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Health facility assessment of small and sick newborn care in low- and middle-income countries: systematic tool development and operationalisation with NEST360 and UNICEF
- Date Crossref
- 07/03/2024
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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London School of Hygiene & Tropical Medicine & Child Health Centre pays non établi dans la noticeUniversité ou école supérieure
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Ifakara Health Institute Department of Health Systems Ifakara Health Institute, Tanzanie (code pays fourni par la source)Organisation à but non lucratif
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Rice University Rice360 Institute for Global Health Technologies pays non établi dans la noticeUniversité ou école supérieure
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Kamuzu Central Hospital Department of Paediatrics Lilongwe, Malawi (code pays fourni par la source)Établissement de santé
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Kamuzu University of Health Sciences Department of Paediatrics Blantyre, Malawi (code pays fourni par la source)Université ou école supérieure
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Ministry of Health Newborn Branch Lilongwe, Malawi (code pays fourni par la source)Organisme public
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Aga Khan University Hospital Nairobi Aga Khan University Hospital Nairobi, Kenya (code pays fourni par la source)Établissement de santé
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Aga Khan University Nairobi Aga Khan University Nairobi, Kenya (code pays fourni par la source)Université ou école supérieure
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AIDS Prevention Initiative in Nigeria Nigéria (code pays fourni par la source)Organisation à but non lucratif
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Blantyre Institute for Community Ophthalmology Blantyre, Malawi (code pays fourni par la source)Organisation à but non lucratif
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University of Malawi Malawi (code pays fourni par la source)Université ou école supérieure
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Kenya Medical Research Institute Nairobi, Kenya (code pays fourni par la source)Structure de recherche
& Child Health Centre — London School of Hygiene & Tropical Medicine, Department of Health Systems — Ifakara Health Institute (Ifakara Health Institute, Tanzanie) et Rice360 Institute for Global Health Technologies — Rice University, avec 9 autres affiliations. Pays d’affiliation : Tanzanie, Malawi, Kenya, Nigéria.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.