Quality of postnatal care on neonatal outcomes among newborns: case study Gulu regional referral hospital

Abstract

The 24 hours during postnatal period remains a significant public health challenge due to its associated morbidities and mortalities. This study assessed the quality of postnatal care provided to postpartum mothers and their newborns at 24 hours after birth at Gulu Regional Referral Hospital. The major objective of this study was to assess quality of postnatal care on neonatal outcomes experienced within the first twenty four hours after birth at Gulu Regional Referral Hospital. This study employed a cross sectional study design that involved studying the postpartum mothers and newborn from delivery up to 24 hours. The women prepared for delivery were sampled randomly on daily basis and studied post-delivery to discharge. Data were collected using semi-structured questionnaire, observation checklist and Key Informants Interview Guide. Data was entered in Microsoft Excel Sheet, cleaned and exported to SPSS, for analysis at univariate where mean, frequencies and percentages were presented. Bivariate analysis was performed to test for significant association and significant variables were considered for analysis at multivariate level to control for confounders. Qualitative data was organized and analyzed according to themes to triangulate the quantitative results. This study found that seven variables were significantly associated with good or normal neonate outcome and these were; essential vaccines (p=0.022), emergency equipment and drugs (P=0.012), adequate healthcare providers (P=0.045), monitoring of the postpartum mother and neonate (P=0.015), counseling and education of postpartum mother on self-care and neonate (p=0.013), physical examination (0.028) and cleanliness of the hospital (0.028). Via multivariable logistic regression, neonates well monitored by healthcare provider was significantly associated with 12% increase in good neonatal outcome (AOR=0.120 95%CI=0.026-0.565, P=0.007*). Counseling and education of the postpartum mothers was significantly association with 8.9% increase in good neonate outcome (AOR=0.089 95%CI=0.015-0.511, P=0.007). Monitoring of the neonates and counseling and education of the postpartum mothers immediately after birth within 24 hours is very important. Therefore, there is need to ensure improvement on close monitoring of the neonates during birth and after birth as well as counseling and education of the postpartum mothers by healthcare provider, avail materials and ensure procedures are followed.