Quality of basic care during neonatal resuscitation at birth among health care providers at three District Hospitals in Kigali City

Abstract

Background: Globally, about 10 % of neonates require extra respiratory support to initiate breathing in the first minutes after birth. Almost 2.7 million of neonates died as an outcome of birth asphyxia and other related problems, then the most occur in low- and middle-income countries (LMICs). Quality of care (QoC) interventions could be done at birth to prevent neonatal deaths through basic care during neonatal resuscitation. Objective: To determine the QoC of basic neonatal resuscitation (NR) at birth among health care providers at district hospitals in Kigali. Method: Observational cross sectional study was conducted from February 20th, 2019 to May 15th , 2019 on 36 health care providers ( HCPs) working in three district hospitals in Kigali city. A structured checklist tool was used to collect data. Descriptive and inferential statistics were used to analyze the data, which was presented in tables and figures. Results: The majority of participants had good QoC scores for drying/stimulation at 74.7%, and fair QoC score for airway clearance (85.1%). A limited number had poor QoC scores for advanced bag and mask ventilation (13%). Years of maternity work experience was associated with good drying/stimulation (β =1.76, Cl= 1.23-2.93, p=0.032), airway maintenance (𝛽 = 1.46, CI = 1.13-2.13, 𝑃 = 0.042) and initial bag and mask ventilation (𝛽=1.66, CI = 1.73-2.97, = 0.019). Conclusion. Quality of care in neonatal resuscitation reflects the preparation, drying and stimulation, airway maintenance, and ventilation, which are critical to save neonates lives. Mentorship and follow up with periodic refresher training can improve the care provided to neonates.