Health Care Providers’ Preparedness on Newborn Resuscitation in Labour Ward and Maternity Theatre at Kenyatta National Hospital

Abstract

Introduction: Preparedness in neonatal resuscitation is critical in delivery rooms for the purpose of saving newborns lives. Neonatal mortality still continue to rise in Africa and one of the main causes of neonatal death is birth asphyxia. Annually136 million newborn are delivered and approximately 10 million require basic resuscitation. Neonatal death can be reduced by performing basic neonatal resuscitation such as drying to stimulate the newborn and assisted ventilation with bag valve and mask. Availability of equipment, knowledge and skills on newborn resuscitation are vital in decreasing neonatal deaths. Objective: To assess healthcare providers’ preparedness on newborn resuscitation in labour ward and maternity theatre of Kenyatta National Hospital (KNH). Methodology: This was a cross-sectional descriptive study. Both qualitative and quantitative approaches were used to determine health care providers’ preparedness on newborn resuscitation, in labour ward and maternity theatre in KNH. Stratified random sampling was used for the different categories for the study population who were doctors, nurses and clinical officers. Simple random sampling was then used to select the sample from each category. Self-administered questionnaires were used to collect data on knowledge on newborn resuscitation, environment and equipment. An observation checklist was used to assess the availability of equipment, drugs and supplies used in resuscitation. Data was analyzed using both descriptive and inferential statistics. Statistical package for social science (SPSS) version 21 was used for analysis. Level of significance was reported at 95% confidence interval P-value less than 0.05. Data was presented in figures and tables. Qualitative data was coded then presented as narrative texts. Results: A total of 100 health care providers in both labour ward and maternity theatre were assessed. Majority were nurses 79(79.8%) and most of them had worked in this units for more than 5 years. Seventy five percent had been trained on newborn resuscitation, 34(45.3%) had been trained on Emergency Triage and Treatment plus (ETAT +). On their knowledge on newborn resuscitation’ 78(78%) had good knowledge. Only 44(44%) of the health care providers identified correct steps of newborn resuscitation. There was no significant association between knowledge and years of experience, cadre or working station however there was significance between training and knowledge on newborn resuscitation P = 0.012. Equipment available were self-inflating bags 5 in each unit. Face mask size 0 was not available whereas size 1 was more than 2 in each unit. 2 Suction machines and a radiant warmer which was attached to the resuscitation table were 2 in each unit though labour ward had only one functional resuscitation table. WHO recommends at least two sets of each equipment to be used during resuscitation. Both units were clean and warmth was well maintained in theatre than in labour ward. Conclusion: There is need to improve health care providers’ preparedness on newborn resuscitation. Knowledge on newborn resuscitation was good however identification of the steps was a challenge. The available equipment in maternity theatre was adequate, labour ward needs more equipment. Environment was conducive for resuscitation in both units though there is need for improvement. Recommendation: Health care providers can improve their knowledge through attending short courses on newborn resuscitation. The hospital management can allocate funds to equip both units with basic equipment needed.