Newborn Care Research Articles

The Effect of using E-Booklet Media on Increasing the Knowledge of Primigravida Mothers about Breastfeeding Techniques and Newborn Umbilical Cord Care

Primigravida mothers often lack sufficient knowledge about newborn care, including umbilical cord care and breastfeeding techniques. Better education and support from healthcare professionals are essential to enhance their knowledge and skills in infant care. Effective training and counseling can help primigravida mothers feel more confident and competent in caring for their children. This study aims to determine the effect of e-booklet media on the knowledge of primigravida mothers regarding breastfeeding techniques and umbilical cord care in the service area of the Pamandegan Health Center and Midwife Clinic. This research uses a quantitative method with a pre-experimental design and a one-group pretest-posttest research design. The sample size in this study was 68 respondents, selected using total sampling, and all respondents received the intervention for 1 month. The measurement tool used in this study was a questionnaire that had undergone normality and validity tests. Normality was tested using the Shapiro-Wilk test, and data analysis was conducted using univariate analysis and bivariate analysis with the Wilcoxon test. The hypothesis test results showed a p-value = 0.000 < 0.05, indicating that the use of e-booklet media significantly affected the knowledge of primigravida mothers regarding breastfeeding techniques and umbilical cord care. It is crucial for primigravida mothers to improve their knowledge in these two aspects as it can greatly impact their ability to care for their babies effectively.

Smartphone apps hold promise for neonatal emergency care in low-resource settings.

Many countries risk failing the Sustainable Development Goal to reduce neonatal mortality to 12 in 1000 live births before 2030, necessitating intervention. This scoping review assesses available evidence from studies implementing smartphone application-based education and clinical decision support in neonatal emergency care in low- and middle-income countries and describes applied assessment tools to highlight gaps in the current literature. A systematic search on 28 March 2024 of PubMed, Web of Science, and EMBASE identified original research papers published in peer-reviewed journals after 2014 in English. The evaluation was based on Kirkpatrick's framework. In total, 20 studies assessing eight different smartphone applications were included. Participants found applications acceptable and feasible in 11 of 14 studies. Knowledge and/or skills were improved in 11 of 12 studies. Behaviour was assessed in 10 studies by tracking app usage. Patient outcome was assessed in four studies, focusing on perinatal mortality, Basic Newborn Care outcomes and correct assessment of newborns. Data from included studies further strengthens hope that smartphone applications can improve neonatal mortality rates in low- and middle-income countries. However, further research into the effectiveness of these applications is warranted. This review highlights gaps in the current literature and provides guidance for future trials.

Enhancement of Nurses' Performance Regarding Care of Newborns at NICUs: An Assessment Study

Enhancement of Nurses' Performance Regarding Care of Newborns at NICUs: An Assessment Study

Neonatal Resuscitation and Delivery Room Care: A Changing Global Landscape.

With 98% of neonatal deaths occurring in low- and middle-income countries (LMICs), leading health organizations continue to focus on global reduction of neonatal mortality. The presence of a skilled clinician at delivery has been shown to decrease mortality. However, there remain significant barriers to training and maintaining clinician skills and ensuring that facility-specific resources are consistently available to deliver the most essential, evidence-based newborn care. The dynamic nature of resource availability poses an additional challenge for essential newborn care educators in LMICs. With increasing access to advanced neonatal resuscitation interventions (ie, airway devices, code medications, umbilical line placement), the international health-care community is tasked to consider how to best implement these practices safely and effectively in lower-resourced settings. Current educational training programs do not provide specific instructions on how to scale these advanced neonatal resuscitation training components to match available materials, staff proficiency, and system infrastructure. Individual facilities are often faced with adapting content for their local context and capabilities. In this review, we discuss considerations surrounding curriculum adaptation to meet the needs of a rapidly changing landscape of resource availability in LMICs to ensure safety, equity, scalability, and sustainability.

Health policies and guidelines to promote, protect and support early childhood development: A narrative review.

This comprehensive review examines the pivotal role of health policies and guidelines in promoting, protecting, and supporting early childhood development (ECD). Recognizing the multifaceted nature of ECD, the study explores key elements commonly found in policies that span health, education, social services, and community support. The focus is on creating an integrated approach that ensures the optimal well-being and growth of children during their formative years. The review highlights the significance of maternal and child health care, emphasizing contact toward prenatal and postnatal care for pregnant women and newborns. Nutritional policies center around supporting breastfeeding and ensuring access to nutritious food, laying the foundation for a healthy start in life. Early childhood education programs and parental education initiatives are crucial components, emphasizing cognitive, social, and emotional development from the earliest stages. The review underscores the importance of a holistic perspective, urging the integration of services across sectors to provide a comprehensive framework for ECD. Research-based policies, continuous monitoring, and evaluation mechanisms ensure evidence-driven decision-making and ongoing refinement of strategies. Additionally, the role of legislation and advocacy is highlighted in protecting the rights and well-being of children and advocating for ECD at various levels. In the end, this review highlights the importance of ECD guidelines and health policies as investments that not only help individual children but also enhance societal productivity and general well-being. By prioritizing the early years, policymakers can lay a strong foundation for future health, learning, and success.

Incidence of medical device-related pressure injuries and identification of risk factors in the neonatal unit

AimThis study was conducted to investigate the incidence of medical device-related pressure injuries (MDRPIs) and the risk factors influencing their occurrence in the neonatal intensive care unit (NICU). MethodThis study is a prospective, descriptive study. The research was conducted with 116 newborns between June 1, 2022, and June 1, 2023. Newborns who stayed in the neonatal intensive care unit for at least 24 h were observed daily for medical device-related pressure injuries under and around each medical device throughout their stay in the intensive care unit. The "Case Report Form," "MDRPIs Monitoring Form," "Braden Q scale for children," National Pressure Injury Advisory Panel (NPIAP) Pressure Grading, and Glasgow Coma Scale were used in the research. ResultsThe incidence of medical device-related pressure injuries is 35.3 % (41/116). It was found that 38.1 % (16/42) of medical device-related pressure injuries developed due to Near-Infrared Spectroscopy (NIRS) probes, and 33.5 % (14/42) developed due to medical devices related to the respiratory system. In terms of anatomical location, 38.1 % occurred on the forehead, and 23.8 % on the arm/leg. The difference between birth weight, gestational age, development of MDRPIs in newborns receiving sedation and inotropes was found to be statistically significant. Regression analysis identified gestational age (p = 0.040, OR = 0.795, 95%CI = [0.632–1.000]) as an independent risk factor for the occurrence of medical device-related pressure injuries. ConclusionsThe incidence of medical device-related pressure injuries in newborns was relatively high in this study, with gestational age being the most significant risk factor for MDRPIs formation. It is crucial for neonatal intensive care nurses to consider associated risk factors while providing newborn care and implement appropriate preventive measures to reduce the incidence of MDRPIs.

Investigation of Perceived Nurse Support and Hopelessness Levels of Mothers with Their Baby in Neonatal Intensive Care

Aim: The investigation aimed to explore the correlation between nurses' perceived support and the hopelessness levels among mothers whose babies are in the newborn intensive care unit. The study used a descriptive, cross-sectional approach focusing on establishing relationships. Method: The research was conducted within the newborn intensive care unit of two distinct clinics in Istanbul from February to July 2021. The study population consisted of 152 mothers whose babies were admitted to the intensive care units of these hospitals. Data collection was conducted using the Nurse Parent Support Tool, Beck Hopelessness Scale, and Personal Information Form. Results: It was found that there was a weak, inverse, and statistically significant relationship between the total mean score of the Nurse-Parental Support Tool and the average score of the Beck Hopelessness Scale. Beck Hopelessness Scale mean scores at first hospitalization and discharge were analyzed. The decrease in findings had a significant statistical effect (p<0.001). Conclusion: The study's findings revealed a statistically significant weak inverse relationship between the average total score obtained from the Nurse-Parental Support Tool and the mean score from the Beck Hopelessness Scale. Specifically, the average scores of the Beck Hopelessness Scale were analyzed both at admission to the hospital and at the time of discharge. It was observed that the data showed a statistically significant drop in the scores between these two events (p<0.001).

Postpartum Depression among Mothers in a Maternity Hospital Kathmandu, Nepal: A Mixed Method Approach

Introduction: Postpartum depression, a significant global concern yet a neglected domain that could have dire outcomes for both mother and children. This study aimed to find out the prevalence of postpartum depression among mothers in the Paropakar Maternity and Women's Hospital & explore the experiences of undergoing pregnancy and post-partum melancholy. Methods: A cross-sectional descriptive study with a mixed method approach and consecutive enumeration of sampling units were done among 271 participants at a maternity hospital, within the study period from July,2023 to Dec, 2023 after obtaining ethical approval (Reg no: 63/1992). Data collection was done through in-depth interviews for the qualitative part among the six respondents and self-administrative questionnaires were opted for the quantitative part among all the respondents. Results: Among the respondents, 203 (74.87%) fall within the 20-30 age range. Among them, 33 (12.24%) mothers experienced post-partum depression. Pregnancy and postpartum experiences were complex, with physical and mental challenges. Women often endured painful pregnancies, including excessive vomiting and pain. Mothers lacked support from family and spouses, impeding daily life and newborn care. Traditional superstitions often trumped medical advice, leading to confusion and risks. Despite challenges, some developed coping mechanisms, like self-counselling and community support.Conclusions: The study highlights the importance of pre-pregnancy assessment and depression screening for postpartum care. Social support is crucial, necessitating holistic support with education, mental health services, and destigmatization efforts for postpartum struggles.

Experiences, barriers and perspectives of midwifery educators, mentors and students implementing the updated emergency obstetric and newborn care-enhanced pre-service midwifery curriculum in Kenya: a nested qualitative study

IntroductionTo achieve quality midwifery education, understanding the experiences of midwifery educators and students in implementing a competency-based pre-service curriculum is critical. This study explored the experiences of and barriers to implementing a pre-service curriculum updated with emergency obstetric and newborn care (EmONC) skills by midwifery educators, students and mentors in Kenya.MethodsThis was a nested qualitative study within the cluster randomised controlled trial investigating the effectiveness of an EmONC enhanced midwifery curriculum delivered by trained and mentored midwifery educators on the quality of education and student performance in 20 colleges in Kenya. Following the pre-service midwifery curriculum EmONC update, capacity strengthening of educators through training (in both study arms) and additional mentoring of intervention-arm educators was undertaken. Focus group discussions were used to explore the experiences of and barriers to implementing the EmONC-enhanced curriculum by 20 educators and eight mentors. Debrief/feedback sessions with 6–9 students from each of the 20 colleges were conducted and field notes were taken. Data were analysed thematically using Braun and Clarke’s six step criteria.ResultsThemes identified related to experiences were: (i) relevancy of updated EmONC-enhanced curriculum to improve practice, (ii) training and mentoring valued as continuous professional development opportunities for midwifery educators, (iii) effective teaching and learning strategies acquired – peer teaching (teacher-teacher and student-student), simulation/scenario teaching and effective feedback techniques for effective learning and, (iv) effective collaborations between school/academic institution and hospital/clinical staff promoted effective training/learning. Barriers identified were (i) midwifery faculty shortage and heavy workload vs. high student population, (ii) infrastructure gaps in simulation teaching – inadequate space for simulation and lack of equipment inventory audits for replenishment (iii) inadequate clinical support for students due to inadequate clinical sites for experience, ineffective supervision and mentoring support, lack/shortage of clinical mentors and untrained hospital/clinical staff in EmONC and (iv) limited resources to support effective learning.ConclusionFindings reveal an overwhelmed midwifery faculty and an urgent demand for students support in clinical settings to acquire EmONC competencies for enhanced practice. For quality midwifery education, adequate resources and regulatory/policy directives are needed in midwifery faculty staffing and development. A continuous professional development specific for educators is needed for effective student teaching and learning of a competency-based pre-service curriculum.

People's Health in People's Hands: Dr. Abhay Bang and Dr. Rani Bang's Pioneering Approach to Rural Healthcare in India.

Dr. Abhay Bang and Dr. Rani Bang, a husband-and-wife team, have dedicated their lives to reforming healthcare in rural India. Their pioneering work in Gadchiroli, Maharashtra, through the Society for Education, Action, and Research in Community Health (SEARCH), has led to revolutionary interventions such as the Home-Based Newborn Care (HBNC) model, significantly reducing infant mortality rates. Their emphasis on women's health and community empowerment has revolutionized conventional healthcare practices and influenced global health policies. This review article sheds light on the historical context and lasting impact of their contributions to community-based healthcare and public health research.

Pengaruh Pengetahuan Ibu terhadap Perawatan Tali Pusat pada Bayi Baru Lahir

Improper care of the umbilical cord can lead to premature detachment and increase the risk of umbilical cord infection (neonatal tetanus). As long as the umbilical cord has not detached naturally, it needs to be properly cared for. Failure to do so can result in infection characterized by moisture, pus, and a foul odor around the umbilical cord. This review aims to determine the influence of mothers' knowledge on the care of the umbilical cord in newborns. This review aims to investigate the impact of mothers' knowledge on the care of the umbilical cord in newborns. This study utilizes a literature review method, utilizing journal articles obtained from Google Scholar, SINTA, and Garuda databases, published between 2019 and 2023, with full text available in the Indonesian language. Based on the reviewed journals, it was found that 7 journals discovered the influence of maternal knowledge on umbilical cord care in newborns, while 4 journals stated that there are still mothers who perform umbilical cord care incorrectly according to the procedure. Based on the literature review of 10 research journals, respondents' characteristics among postpartum mothers can be classified based on age, educational level, and occupation. All these factors significantly impact a mother's knowledge regarding the care of the umbilical cord in newborns, highlighting the importance of health education in enhancing maternal knowledge.

Exploring epidemiological maternal risk factors associated with the cases of birth asphyxia: a study at civil hospital, Ahmedabad

Background: Maternal health is crucial for fetal growth; certain risk factors were identified which can affect development. Birth asphyxia, a preventable condition among the newborns, which can be managed with appropriate care during pregnancy, delivery, and post-delivery. This study aimed to identify maternal risk factors for birth asphyxia in newborns. Early recognition and timely preventive measures can lower the morbidity and mortality linked to asphyxia. Methods: The cross-sectional study was conducted over a one-year period. The mothers of asphyxiated newborns were selected for the study. Data was collected using a pretested, semi-structured questionnaire and analyzed using MS Excel and SPSS 26 Results: 150 mothers were selected for the study based on the inclusion criteria. Among the maternal risk factors, late registered pregnancies and the mother who suffered prolonged labor were significantly associated with the severity of asphyxia. Newborn of pregnant women who had history of consumption of smokeless tobacco had significantly more risk of developing hypoxic ischemic encephalopathy (HIE). Conclusions: To improve neonatal outcomes, focusing on antenatal pediatrics is essential. Early detection and referral of maternal risk factors such as lack of ANC visits, consumption of smokeless tobacco and maternal anemia can prevent adverse outcomes and ensure better care for newborns.

Cultural practice and determinants of newborn care in rural areas of Ramanagara district in Karnataka: a community-based study

Background: There is considerable drop in neonatal mortality in India attributing to strategies by the National Health Mission and in rural areas cultural practices also plays role. The knowledge of recent cultural practices was intended and thus, the objective of this study was to explore the cultural practices and determinants in neonatal care in rural areas of Ramanagara district. Methods: The community based, cross sectional, descriptive and exploratory study was done in selected villages. The recently born baby in the family was included as subject irrespective of their birth order and sex. Data collected by direct interview of mothers at their door steps using the pre tested, semi open-ended questionnaire containing relevant information about cultural practices in the family. Data was analysed in SPSS software version 23. Results: Sex ratio among 550 newborns was 1:1. Birth orders of first and second or above were 59.5% and 40.5%. Majority of the mothers delivered at government hospitals (95%) and by vaginal delivery. The duration of hospital stay was less than 3 days in 52.5%. Breast feeding was initiated among 98% within 24 hours after birth, first bathing and oil massage after birth was within 7 days and 14 days respectively in majority. The prevalence of LBW was 19.5% and pre lacteal feeding was 21.1%. Conclusions: The newborn care practices are better in this community. However, the pre lacteal and top feeding practices to be discouraged by appropriate health education to the mothers and care takers immediately after birth.

Changes in skin barrier over the first four days of life: a cross-sectional study.

We aimed to evaluate the trajectory of skin barrier properties in full-term newborns during the first four days after birth. Based on the MKNFOAD cohort (NCT02889081), transepidermal water loss (TEWL), stratum corneum hydration (SCH), skin pH, and sebum content at five anatomical sites (cheek, forehead, volar forearm, abdomen, and dorsal lower leg) were examined once within 96 h after birth in 384 full-term infants. Multivariable linear regression analysis was performed to assess variations in these skin barrier parameters with age adjusted for gestational age, neonate's sex, parents' allergy history, delivery mode, amniotic fluid characteristics, and birth weight. The regression coefficient (ß) and 95% confidence interval were reported. We analyzed a total of 384 neonates including 198 (51.6%) boys. TEWL values remained stable and showed no significant association with age (days). pH values exhibited a declining trend with age (p for trend <0.001). Both SCH values and sebum content grew with age (p for trend <0.001). During the first four days after birth, the skin TEWL remained stable, pH decreased, and the SCH and sebum content increased over time. These findings provide insights into the neonatal skin physiological development at the beginning of life. From birth to 96 h, TEWL was stable, pH showed a steep decline, SCH and sebum content increased. This study provides the first evidence of skin adaptation in the newborn due to changes in utero to after birth in the first 4 days of life in an Asian population. These findings will provide a new theoretical basis for neonatal skin physiology and clinical strategies for guiding newborn skin care.

Perspectives of midwives on the use of Kaligutim (local oxytocin) for induction of labour among pregnant women in the government hospitals in Tamale

BackgroundThe use of herbal medicine and/or its products is common throughout the world. In Tamale Metropolis, pregnant women frequently use local oxytocin to induce labour, as shown by the fact that 90% of midwives reported managing patients who used kaligutim (local oxytocin) to speed up labour. Early career midwives are also aware of this and have personally observed it being used by their clients. The purpose of the study was to assess midwives’ opinions on pregnant women’s use of the well-known kaligutim (local oxytocin) for labour induction in the Tamale Metropolis.MethodsA facility-based, quantitative, cross-sectional research design was used for the study. A total of 214 working midwives from Tamale’s three main public hospitals participated. Data for the study were gathered through a standardized questionnaire. For the analysis and presentation of the data, descriptive and analytical statistics, such as basic frequencies, percentages, Fisher’s exact test, chi square test and multivariate analysis, were employed.ResultsAccording to the findings of this study, the safety, dosages, and contraindications of kaligutim during pregnancy and labour are unknown. The cessation of contractions was reported by 44 (22.4%) of the respondents whose clients used local oxytocin. The study also revealed that women in Tamale metropolis use “walgu”, a spiritual form of oxytocin, to induce and augment labour. Respondents who responded, “yes” to baby admission to the new-born care unit were 25% more likely to use kaligutim (local oxytocin) than were those who responded, “no” to baby admission to the new-born care unit (AOR = 0.25 95% CI (0.01, 0.53), P = 0.021).ConclusionsIt can be concluded that using kaligutim to start labour has negative effects on both the mother and the foetus. Additional research is required to evaluate the efficacy, effectiveness, biochemical makeup, and safety of these herbal medicines, particularly during pregnancy and delivery, as well as the spiritual significance of kaligutim (Walgu) and its forms.

Evaluation of Anxiety Levels and Family-Centred Care Receipt Status among Turkish Mothers with Babies Admitted to the Neonatal Unit: A Two-Centre Study

This study was conducted to evaluate the anxiety levels and family-centred care receipt status of mothers whose babies were treated in the neonatal intensive care unit (NICU). This research was conducted in a descriptive and cross-sectional design between January and December 2022 in the NICU of two separate hospitals, one of which is a university hospital, and the other is a public hospital located in the east of Turkey. An Introductory Information Form, Spielberger State-Trait Anxiety Inventory, and Newborn Family-Centred Care Scale were used to collect data. The mothers’ state anxiety level mean score was 41.51±9.6, their trait anxiety level mean score was 40.31±7.7, and they experienced a moderate level of anxiety. The total mean score of the Newborn Family-Centred Care Scale was 3.7±0.7 (min 1-max 5). Mean scores from the subscales were 4.0±0.7 for dignity and respect, 3.9±0.8 for information sharing, 4.0±0.8 for participation in care, and 3.3±1.1 for cooperation with the family. A significant negative relationship was found between the mothers’ family-centred care scale total score and mean subscale scores and their state and trait anxiety levels (p

A mixed-method analysis of provider adherence to integrated antenatal care guideline in BEmONC and Non BEmONC primary health center: An Indonesian case.

Provider adherence to the integrated antenatal care (ANC) procedure is an important indicator of high-quality ANC. The procedure is intended to avoid missed opportunities to detect the risk of abnormalities in pregnancy. This study aims to assess the provider's adherence to integrated ANC in Basic Emergency Obstetric and Newborn Care (BEmONC) and non-BEmONC Primary Health Center (PHC). This study employed an explanatory sequential mixed-method design. The quantitative phase reviewed 149 medical records of pregnant women in the four PHCs in Semarang from January until February 2020. The findings were used to describe the provider's adherence to the integrated ANC and lead to the contributing factors which should be explored in the qualitative phase. The study involved four in-depth interviews with midwife coordinators in four PHCs. The Mann-Whitney and Chi-square test was employed to analyse the quantitative data, while the thematic analysis was undertaken on the qualitative data. The provider's adherence to the guideline did not differ between BEmONC and non-BEmONC PHC. The general physical examination of the patients (18.81%) and dentist visits (84.6%) were not done in either BEmONC or non-BEmONC PHC. Incomplete laboratory tests were haemoglobin (28.2%) and urine protein (38.9%). The barriers to adherence to the integrated ANC guideline were related to an imbalance of resources, role and responsibility issues among doctors and midwives, and policy issues. This study found low BEmONC nor non-BEmONC PHC adherence to the integrated ANC guideline. A Periodic evaluation of the implementation of integrated ANC to ensure its high-quality implementation in Indonesia is needed.

Comparative Analysis on Safe Traditional Practices by Iraqi and Philippine Mothers in the Treatment of Newborn Health Problems: A Narrative Review

Background: Traditional practices are usually derived from the relationships with the environment and human attitude towards nature. Various societies, especially in developing nations, have unsafe traditional practices for newborns, traditionally associated with poverty, low educational levels, religiosity, culture, and by word of mouth intergenerationally handed over advice by elders in the families. Objectives: This narrative review points out the prevalence, cultural significance, and health implications of unsafe traditional newborn care practices in Iraq and the Philippines. Methods: Literature was searched in PubMed, Scopus, Web of Science, CINAHL, and Google. All iterations searched literature among mothers whose neonates were at issues, favoring traditional techniques rather than modern medicine—a total of 51 articles to be reviewed from articles published from 2019 to June 2024. Results: The following ten critical themes of unsafe practices were identified: care of the umbilical cord, feeding, traditional healing, bathing rituals, circumcision, swaddling, and treatments for gastrointestinal, respiratory, and eye problems, besides newborn isolation and practices of exposure. All these practices are comparatively prevalent in the rural setup and are ingrained in the fabric of cultural beliefs and traditions. These could include exposure to infection, complications, developmental delays, and neonatal mortality. The practices have also been associated with the perpetuation of poverty, low literacy levels, and cultural backgrounds. Conclusion: This review indicates that interventions towards these problems have to be multi-faceted. Multiple dimensions can be integrated into evidence-based interventions to improve education and economic opportunities, engagement with religious and cultural leaders, health system strengthening, fomenting research, and community engagement to develop culturally relevant solutions linking tradition and evidence-based care to improve newborn health outcomes.

An Investigation into how Primary Care Nurses Practices affect clinical competence in Emergency Maternal Obstetric and Newborn Care skills in Nakuru County

To reduce the risks of maternal morbidity, mortality and newborn death worldwide, the use of high-quality emergency obstetric and new born care (EMONC) was proposed to ensure women and their babies receive high-quality care. The government of Kenya with non-profit health programs have jointly invested resources with the aim of achieving SDG’s goal of zero rating maternal and neonatal death cases in the country. Despite these efforts, maternal and neonatal death cases have not reduced significantly. Most of the contributing factors to the deaths occur in the lower levels of the health care delivery system. Majority of the health care providers at these levels are the primary care nurses. It is on this background that the study sought to investigate how primary care nurses practice affect clinical competency in emergency maternal, obstetric, and new born care skills in Nakuru county. Madeleine Leininger’s Transcultural Theory of Nursing anchored the study. It deployed correlational cross-sectional survey design, targeting midwives and nurses in 184 KEPH level II and III facilities in all the 11 sub counties in Nakuru County. The study used stratified sampling technique to sample 126 health facilities distributed in every Sub County. A sample size of 196 primary health care nurses from the sampled facilities were involved. Key informant interview and questionnaires were used to collect both qualitative and quantitative data. To analyze data, SPSS version 26 was used to generate inferential and descriptive statistics, correlation analysis was carried using multiple regression model to ascertain the relationship between dependent and independent variables. Results found that Maternal and newborn care practice was found to have a significant positive relationship with competence in EmONC skills. (P&lt;0.05). This was achieved through clean and safe delivery, thermal care and cord care which were carried out in KEPH level II and III facilities. It was concluded that maternal and neonatal care practices had positive significant relationship with competent EmONC. The study advised that the practice of fundamental maternal and newborn care has to be improved. The primary care nurses should be culturally competent in engaging the community members. Through community-based health care efforts, mothers need to be sensitized about delayed bathing, umbilical cord care, feeding, and thermal care for newborns. Further, County Government of Nakuru should support programs that enables primary health care nurses pursue maternal and neonatal care courses. County Government of Nakuru should ensure ambulance services are easily accessible to all, equipment availability at all time, consistent supply of all drugs needed and the need to create awareness among women, family and community members on newborn and early neonatal care

Postnatal quality of care measures for mothers and newborns at home: A scoping review.

The postnatal period is one of the most critical periods in the lives of mothers and newborns. Yet, the postnatal period remains the most neglected period along the maternal health care continuum. Globally, measures assessing quality of postnatal care (PNC) often focus on care at health facility level, the provision of home-based PNC and associated quality of care measures seem largely overlooked. This scoping review aims to give an overview of the literature on measures assessing quality of PNC for mothers and newborns in a home-based setting. This review was conducted according to the Arksey and O'Malley's methodology for scoping reviews. Three electronic bibliographic databases were searched together with a grey literature search. Two reviewers independently screened the identified articles. All data on home-based PNC measures were extracted and mapped according to the 2022 World Health Organization PNC Guideline recommendations in three categories: i) maternal care, ii) newborn care, iii) health system and health promotion interventions. Several additional quality of care domains, characterizing home-based PNC, were identified: i) social and emotional empowerment, ii) assessment of the home setting, iii) early breastfeeding, iv) health education and counseling, v) personal hygiene and prevention of infections, vi) referral to health facility when necessary, vii) thermal care, viii) parent-child relationship and ix) promote economic self-sufficiency. This review illustrates that home-based PNC has a very broad spectrum of care and plays a vital role in improving maternal and newborn health and well-being. In addition, there is a clear need for more research on the optimal timing and content of home-based care in the postnatal period for maximizing its potential.