Quality of Neonatal Health Care: Learning From Health Workers’ Experiences in Critical Care in Kilimanjaro Region, Northeast Tanzania

Abstract

Background: Neonatal deaths are generally attributed to suboptimal standards of health care. Health care worker region. Methods: A descriptive study using a semi-structured interview for health care workers at a tertiary referral hospital and peripheral health facilities (regional referral, district hospitals and health centres).was used. Health Care Workers (HCW) were asked to recall a scenario of a critically ill neonate admitted in the wards and the treatment that was provided. The WHO Emergency Triage Assessment and Treatment (ETAT) guidelines were used as a standard reference for knowledge of critical care. Results: Birth asphyxia was the most recalled health problem requiring critical care, reported by 27.5% of 120 HCW at both peripheral hospitals and by 46.4% of 28 health workers in tertiary referral centres. Half of the HCW commented on their own performance (47.5%, n=140). HCW presented with low to moderate levels of knowledge for critical care were at 92%. Supplementary training was associated with a higher levels of knowledge of neonatal critical care (p value = 0.05). HCW in peripheral hospital had lower levels of knowledge (only 44.7% at peripheral hospitals had sufficient ratings compared to 82.1% at the referral centre). [Pearson χ 2 (2) = 12.10, p value = 0.002]. Conclusion: Guided Practical-Competence Diagnostic Specific neonatal health care training is highly needed in the peripheral facilities of rural Kilimanjaro region.