Abstract
BackgroundThe Community-Based Newborn Care (CBNC) program is a comprehensive strategy designed to improve the health of newborns during pregnancy, childbirth, and the postnatal period through health extension workers at community levels, although the implementation has not been evaluated yet. Therefore, this study aimed to evaluate the process of the CBNC program implementation in Geze Gofa district, south Ethiopia.MethodsA case study evaluation design with a mixed method was employed from May 1 to 31, 2017. A total of 321 mothers who gave birth from September 01, 2016 to February 29, 2017, were interviewed. Similarly, 27 direct observations, six-month document reviews, and 14 key informant interviews were conducted. The quantitative data were entered into Epi-Data version 3.1 and exported to SPSS version 20 for analysis. In the multivariable logistic regression analysis, variables with < 0.05 p-values and Adjusted Odds Ratio (AOR) with 95% Confidence Interval (CI) were used to declare factors associated with maternal satisfaction. The qualitative data were transcribed, translated, coded, and analyzed using thematic analysis. The overall process of program implementation was measured based on pre-determined judgmental criteria.ResultsThe overall level of the implementation process of the CBNC program was 72.7%, to which maternal satisfaction, availability of resources, and healthcare providers’ compliance with the national guideline contributed 75.0, 81.0, and 68.0%, respectively. Essential drugs and medical equipment, like vitamin K, chlorohexidine ointment, neonatal resuscitation bags, and masks used in the program were out of stock. Very severe diseases were not treated according to the national guidelines, and the identification of neonatal sepsis cases was poor. Trading occupation (AOR: 0.16, 95% CI: 0.03–0.97) and low wealth status (AOR: 3.11, 95% CI: 1.16–8.36) were factors associated with maternal satisfaction.ConclusionThe process of CBNC program implementation was relatively good, although the compliance of healthcare providers with the national guideline and maternal satisfaction with the services was low. Some essential drugs and medical equipment were out of stock. Merchant and low wealth status affected maternal satisfaction. Therefore, healthcare offices should provide crucial medicines and equipment for better program implementation and improve the wealth status of mothers to enhance maternal satisfaction.
Highlights
The Community-Based Newborn Care (CBNC) program is a comprehensive strategy designed to improve the health of newborns during pregnancy, childbirth, and the postnatal period through health extension workers at community levels, the implementation has not been evaluated yet
The study population for the evaluation included mothers who gave birth from September 01, 2016 to February 29, 2017, Health Extension Workers (HEWs)’ who are working at health posts in the district for more than a year, head of the district health office, focal persons of the Primary Health Care Unit (PHCU), and CBNC service documents
In the multivariable logistic regression analysis, a p-value less than 0.05 and Adjusted Odds Ratio (AOR) with a 95% Confidence Interval (CI) were taken to declare factors associated with maternal satisfaction
Summary
The Community-Based Newborn Care (CBNC) program is a comprehensive strategy designed to improve the health of newborns during pregnancy, childbirth, and the postnatal period through health extension workers at community levels, the implementation has not been evaluated yet. A study conducted in the Morogoro region, Tanzania, showed that 73, 40, 37, and 35% of the cadres of community health workers (CHWs) recalled family planning messages, postpartum care, HIV transmission, and nutrition, respectively. An evaluation conducted in Ghana indicated that 70% of mothers received community-based volunteer visits during their postnatal period, while only 76% of the babies had their respiratory rate, temperature, and weight assessed [4]. A study conducted in Malawi showed that only 36% of women received at least one home visit by health surveillance assistants during their recent pregnancies, whereas 10.9% received post-delivery home visits in the recommended three-days [5]
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