Assessment of immediate newborn care practices among healthcare workers in Moi teaching and referral Hospital (MTRH) Kenya

Abstract

Introduction: Care of all newborns includes immediate and thorough drying, skin to skin contact of the newborn with the mother, cord clamping and cutting after the first minutes after birth, early initiation of breastfeeding, and exclusive breastfeeding. Labour, birth and the immediate postnatal period are the most critical for newborn and maternal survival. Health care professionals in general play a role to ensure that the newborn has best possible beginning of life, be aware of the potential problems and be alert to the infants changing condition and to intervene appropriately when necessary. Objectives: The study aimed at description of the activities done in preparation for delivery and newborn care, the immediate care provided to newborns and to determine performance of potentially harmful newborn practices. Methods: This was a cross sectional study, carried out in the MTRH. The study subjects were all health care practitioners (39) involved in immediate care of neonates, the sampling method was a census, and an observational checklist was used to collect the data. Analysis was performed using variance statistics. Significance level was set at α=0.05. Results: A total of 39 health care workers participated in the study. Most items were available in the delivery room, sterile gloves (100%), clean gloves (97.4%) and hand sanitizer (64.1%). Initiation of breastfeeding within the first hour of birth is at 70.5%, reasons such as resuscitation of newborn, repair of episiotomy/tears were cited for not initiating breastfeeding. Performance of inappropriate newborn practices such as lack of provision of heat source during delivery (46.2%), inadequate drying of head (23.1%) and placements on a cold surface were noted (3.9%). Conclusion: Study findings highlight the fact that quality of care was good in areas such as preparation of items before delivery (sterile and clean gloves), initiation of breastfeeding within first hour of birth, but it was poor in relation to unavailability of heat source and inadequate drying of newborn. Recommendations: Provision of the needed supplies and items before each delivery and equipment (heat source) for provision of recommended immediate newborn care.