| Assessment of health facility capacity to provide newborn care in Bangladesh, Haiti, Malawi, Senegal, and Tanzania |
| Authors: |
Rebecca Winter, Jennifer Yourkavitch, Wenjuan Wang, and Lindsay Mallick |
| Source: |
Journal of Global Health, 7(2): 020509; DOI: 10.7189/jogh.07.020509 |
| Topic(s): |
Health care utilization
Maternal health
|
| Country: |
Africa
Malawi
Tanzania
Senegal
Asia
Bangladesh
Latin American/Caribbean
Haiti
|
| Published: |
DEC 2017 |
| Abstract: |
Background Despite the importance of health facility capacity to provide
comprehensive care, the most widely used indicators for global monitoring
of maternal and child health remain contact measures which assess
women’s use of services only and not the capacity of health facilities to
provide those services; there is a gap in monitoring health facilities’ capacity
to provide newborn care services in low and middle income countries.
Methods In this study we demonstrate a measurable framework for assessing
health facility capacity to provide newborn care using open access,
nationally–representative Service Provision Assessment (SPA) data
from the Demographic Health Surveys Program. In particular, we examine
whether key newborn–related services are available at the facility (ie,
service availability, measured by the availability of basic emergency obstetric
care (BEmOC) signal functions, newborn signal functions, and
routine perinatal services), and whether the facility has the equipment,
medications, training and knowledge necessary to provide those services
(ie, service readiness, measured by general facility requirements,
equipment, medicines and commodities, and guidelines and staffing) in
five countries with high levels of neonatal mortality and recent SPA data:
Bangladesh, Haiti, Malawi, Senegal, and Tanzania.
Findings In each country, we find that key services and commodities
needed for comprehensive delivery and newborn care are missing from
a large percentage of facilities with delivery services. Of three domains of
service availability examined, scores for routine care availability are highest,
while scores for newborn signal function availability are lowest. Of
four domains of service readiness examined, scores for general requirements
and equipment are highest, while scores for guidelines and staffing
are lowest.
Conclusions Both service availability and readiness tend to be highest
in hospitals and facilities in urban areas, pointing to substantial equity
gaps in the availability of essential newborn care services for rural areas
and for people accessing lower–level facilities. Together, the low levels of
both service availability and readiness across the five countries reinforce
the vital importance of monitoring health facility capacity to provide care.
In order to save newborn lives and improve equity in child survival, not
only does women’s use of services need to increase, but facility capacity
to provide those services must also be enhanced. |
| Web: |
http://jogh.org/documents/issue201702/jogh-07-020509.pdf |
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