Capacity of private health failities to care for newborns in Jinja District, Uganda

Abstract

Uganda has a high neonatal mortality rate (NMR) at 27 per 1000 live births. One of the reducing trategies for NMR is to ensure that health facilities have adequate capacity to care for newborns. 13% of mothers in Uganda deliver at private health facilities (PHFs). However, there is a dearth of information on the capacity of these facilities to care for newborns. Inadequate capacity could result into inappropriate newborn care practices among mothers delivering at these facilities thus contributing to the NMR. This study aimed at assessing the capacity of private health facilities to care for newborns in Jinja district using provider and client perspectives.

Methodology A cross sectional study was conducted at 13 private health facilities (PHFs) where delivery services are provided. The study population comprised of mothers who had delivered at the PHFs in the 6 months prior to the study, health workers who deliver mothers or treat sick newborns at these facilities and the PHFs themselves. Data was collected using structured questionnaires and checklists. Analysis was done using STATA 10.0 and Microsoft excel.

Results Despite the majority (12/13) of the PHFs having a qualified health worker to conduct deliveries and care for newborns, many (9/32) of the health workers providing these services were nursing assistants, a cadre not authorized by training to provide these services. Only 5 out of the 13 PHFs had at least 1 health worker trained on newborn care in the 3 years preceding the study, and 2 out of 13 had at least 1 health worker supervised on newborn care in the 2 years preceding the study. None of the PHFs had all the required items in the domains of essential medicines, equipment, supplies, infrastructure and registers, while only one had all the recommended guidelines at the time of the assessment. The level of knowledge on essential newborn care among both mothers and health workers was low with exception of level of knowledge on breastfeeding. Mothers’ uptake of recommended newborn care practices was low with exception of timely initiation of breastfeeding after delivery (92%).

Conclusion and recommendations The capacity of PHFs to care for newborns in Jinja district is inadequate, and this is reflected in the low levels of knowledge and uptake of recommended newborn care practices among mothers delivering at these facilities. PHFs should be equipped with basic equipment and guidelines, as well as offered training and support supervision for newborn care.