Practices of essential newborn care endorsed for every newborn and interventions recommended for pre-term babies in selected government hospitals of Colombo District, Sri Lanka

Abstract

Introduction: World Health Organization (WHO) has identified essential newborn care interventions to improve the care of every newborn. In 2015, the WHO published evidence-based guidelines to improve pre-term birth. Though Sri Lanka also adheres to these recommendations on interventions to improve pre-term birth outcomes, coverage of them have not yet been assessed for the country and there is no recent assessment of essential newborn care coverage as well.Objectives: To describe the practice of essential newborn care (ENC) for babies born pre-term and WHO recommended interventions to improve pre-term birth outcomes in government hospitals of Colombo District.Methods: A descriptive cross-sectional study with two components was conducted in seven government hospitals with obstetric and neonatal care facilities in Colombo District in 2017-2018. The first component describes the coverage of essential newborn care (ENC) assessed by direct observation among convenient sample of 77 deliveries. The second component assessed the practice of recommended interventions to improve pre-term birth. Data were extracted by pre-intern doctors from the medical records using a checklist on 510 pre-terms. Descriptive analysis was done.Results: In relation to ENC, among 77 deliveries, preparation before delivery was satisfactory and it was >90%. Overall, the practice of immediate newborn care interventions were satisfactory, but a low coverage was found for maternal abdomen delivery 31(40.3%), delayed cord clamping 39 (50.6%), temperature measurement 8(10.4%), educating about vitamin K 29 (37.7%), breastfeeding counselling 40 (51.9%) and delayed weighing 26 (33.8%). Practising recommended pre-term interventions was satisfactory except for the use of magnesium sulphate which was received by only 38 (60.3%) and kangaroo mother care was given for only 74 (57.8%).Conclusions & Recommendations: Most of the ENC practices and adhering to recommended interventions for pre-term were satisfactory except for a few. A refresher course of care for the preterm baby and ENC is recommended to the labour room staff.