Adherence to the early essential newborn care guidelines at Dong Thap General Hospital in 2021

Abstract

Objectives: Describe the adherence to the early essential newborn care (EENC) guidelines in normal deliveries and influencing factors at Dong Thap General Hospital.

Methods: This is cross-sectional study design applying mixed method. Quantitative data was collected by observing 90 normal deliveries using checklist following 40 steps of EENC procedure guideline of the Ministry of Health. Qualitative data were collected from 26 key informants including 4 in-depth interviews (IDIs) with Hospital managers and 3 focus group discussions (FGDs) with midwives. Quantitative data was analyzed using descriptive statistics. Qualitative data was recorded, transcribed, and analyzed by thematic coding.

Results: The rate of 90 normal births that were fully adhered to all 40 steps of the EENC procedure by midwives was only 14.4%. The rate correctly following 35-39 steps was 55.6%, 30-34 steps was 28.9%, and 27- 29 steps was 1.1%. Qualitative data showed that factors positively influenced the adherence to the EENC were managers’ commitment to implement the guideline, infrastructure investment, training on EENC for staff. Whereas, factors negative affected the adherence to the EENC were inappropriate procedure, ineffective supervision and monitoring, the lack of human resources and heavy workload, and lack of collaboration of mothers.

Recommendations: Dong Thap General Hospital needs to review the content of the procedure, periodically to conduct more effective supervision and monitoring, improve workforce management at Obstetric Department to ensure the implementation of the procedure; promote communication/counseling for mothers and relatives to collaborate with midwives in implementing the EENC procedure.