Integrated review of healthcare provider postnatal newborn care recommendations in Sub‐Saharan Africa

Abstract

To (1) identify formal and informal healthcare provider knowledge and counselling on newborn care recommendations; (2) identify care guidelines used; and (3) determine healthcare provider training regarding recommendations. In sub-Saharan Africa, many newborn deaths occur in the community between days two to 42 of life. Formal and informal healthcare providers, including nurses and community health workers, counsel newborn caregivers but little is known about their recommendations. Integrative review of studies conducted 2000-2018 after search of PubMed, CINAHL, Embase, and African healthcare journals. Study quality was assessed and findings synthesized. Twelve qualitative, quantitative, or mixed-methods studies (quality good to poor) from seven countries were included. Eleven reported on one to three recommendations; one study reported on eight recommendations. Knowledge or counselling on feeding, cord care, recognizing illness, referrals, informal treatment, home visits, immunizations, follow-up examinations, thermal care, low birthweight, and bed net usage were reported. Formal healthcare providers gave recommendations in only two studies. Four studies documented use of guidelines. Six studies reported on training. Studies were primarily descriptive, limiting quality. Feeding and cord care recommendations were prioritized. Care guidelines were underutilized. Additional training on recommendations is needed. These findings regarding healthcare providers align with other regions with high neonatal mortality. Research is needed to improve and sustain knowledge, counselling, and guideline usage among providers to address neonatal mortality. The unique role of nurses to promote newborn health appears under-researched. Nurse professionalization and specialization may contribute to sustained knowledge of and counselling on newborn recommendations. As countries adopt universal health care, policies that enable formal providers to encourage maternal-newborn engagement in newborn health promotion before transition to the community are needed. Collaboration between formal and informal providers may improve dissemination of recommendations and contribute to gains in newborn health.