Health staff experiences with the implementation of early essential newborn care guidelines in Da Nang municipality and Quang Nam province in Viet Nam

Marianne S Morseth,Ha T T Vu,Laura Terragni,Roger Mathisen,Quang V Ngo,Tuan T Nguyen,Sigrun Henjum,Malene Skui

doi:10.1186/s12913-020-05449-2

Marianne S Morseth, Ha T T Vu + Show 6 more

Open Access

https://doi.org/10.1186/s12913-020-05449-2

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Abstract

BackgroundThe World Health Organization (WHO) recommends early essential newborn care (EENC) – The First Embrace – as a simple lifesaving procedure for newborns. The successful implementation of EENC at scale requires an understanding of health staff experiences, including facilitators, barriers, and local adaptations of EENC. This study aims to gain insight into health staff experiences with implementation of EENC guidelines after participation in training and coaching initiatives in Da Nang municipality and Quang Nam province in Viet Nam.MethodsIn each province/municipality, we randomly selected one hospital from the following categories: public provincial/municipal hospital, public district hospital, and private hospital. We conducted in-depth interviews with 19 hospital staff (11 midwives, 5 doctors and 3 health managers) and two trainers during 7 days between September and October 2017. We used deductive/inductive thematic analysis to generate themes.ResultsThe health staff reported improved staff and mother satisfaction, and health benefits for both mothers and newborns after implementing EENC. Facilitators to successful implementation were management support for resource allocation and collaboration across departments, and creative demand generation. Barriers included staff shortage, skepticism about the new protocols and practices and challenges translating knowledge and skills from trainings and coaching into practice.ConclusionsAfter implementing EENC, through training and coaching using the WHO approach, health staff reported improved staff and mother satisfaction as well as health benefits for both mothers and newborns. An approach to develop competencies, with a focus on practical training and coaching, should be promoted to form, reinforce and sustain recommended EENC practices among health staff.

Highlights

The World Health Organization (WHO) recommends early essential newborn care (EENC) – The First Embrace – as a simple lifesaving procedure for newborns
One of the efforts initiated by the World Health Organization (WHO) to reduce early neonatal mortality is the promotion of Early Essential Newborn Care (EENC), which ensures quality of care during childbirth and during the first 24 h after [8]
After successful implementation in eight prioritized member states in the regions, the WHO Regional Office for the Western Pacific Region issued a comprehensive package for EENC training and coaching [10] and is rolling out the guidelines beyond the region [11]

Summary

Introduction

The World Health Organization (WHO) recommends early essential newborn care (EENC) – The First Embrace – as a simple lifesaving procedure for newborns. This study aims to gain insight into health staff experiences with implementation of EENC guidelines after participation in training and coaching initiatives in Da Nang municipality and Quang Nam province in Viet Nam. The United Nations’ Sustainable Development Goals aim to end preventable deaths of newborns and children under 5 years of age by 2030, including reducing the neonatal mortality rate from 19 to 12 deaths per 1000 live births, and lowering the under-5 mortality rate from 43 to 25 deaths per 1000 live births [1, 2]. One of the efforts initiated by the World Health Organization (WHO) to reduce early neonatal mortality is the promotion of Early Essential Newborn Care (EENC), which ensures quality of care during childbirth and during the first 24 h after [8] These guidelines present a set of steps consisting of immediate and thorough drying of the newborn, immediate skin-to-skin contact, delayed umbilical cord clamping until pulsations stop, and early initiation of breastfeeding (EIBF) [7]. The process includes 1) updating monitoring and evaluation data to check status, track progress, and identify action to strengthen implementation, 2) reinforcing EENC policy, planning and coordination, and 3) putting into practice EENC and providing coaching and quality improvement [11, 12]

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