Immediate newborn care and associated outcomes in the delivery room: an observational study in Rwanda.

Abstract

Background: Globally, almost half of under-five deaths are newborns, yet about 80% of these are preventable using cost-effective intervention. Each year, one million of neonatal deaths occur due to perinatal problems including asphyxia and hypothermia from delivering room. Aim: To assess immediate newborn care and associated outcomes in delivery room at a selected District Hospital in Rwanda. Methods: The study was a quantitative description with cross sectional design. Sampling strategy was convenience in order to get a sample size of 171 newborns in delivery room at the site setting in 2019. The checklist was used to collect data. The data was analyzed by using SPSS version 21. Test used were Chi-square test and logistic regression to identify the variables relationship. IRB ethical clearance and approval letter from the hospital were given prior to collect data. Results: The majority immediate newborn care included newborn dried thoroughly 129 (75.4%); skin to skin contact 115(67.3%); delayed cord clamping and cut116 (67.9%); proportion of resuscitated (bag mask) 10 (5.8%) of all newborn had birth asphyxia and 100% of them were well resuscitated within one minute; physical assessment103 (60.2%). However, only a limited number of newborns initiated breastfeeding within one hour 17 (9.9%). The practice show the significant on suction and resuscitation materials not available to be associated good outcome (stable) with (OR=3.222, 95% CI=1.324-7.655, P-value=0.029); mouth and nose cleared if meconium (OR=10.965.95% CI=2.154-25.850. P.value=0,004) Conclusion: The majority of newborns were stable within the first hour after birth. However, nearly one quarter was unstable and required intervention. There is a need of protocol and guideline concerning initiation of breastfeeding in labor ward due to results showed a limited number of initiation of breastfeeding.