Determinants of health facilities to provide new born care services in Ethiopia

finding from the service availability and readiness assessment 2018

Abstract

Introduction: Almost 50% of under-five mortality occurs during the neonatal period. Sub-Saharan Africa has the highest rates of neonatal mortality. In this study, we assessed the availability of emergency newborn care services and readiness of health facilities to provide the services, readiness variation by type of facility, managing authority, location and regions in Ethiopia.

Method: Using data from the 2018 Ethiopian Service Availability and Readiness Assessment (SARA), a newborn care services readiness score was calculated from ten tracer items. The mean availability score was created for measuring health facilities overall capacity to provide newborn care services. The factors that determine health facilities to provide newborn care services include the type of facility, managing authority, region, availability of power, water, emergency transport an infant weighing scale. A multiple linear regression model was used to determine factors associated with the readiness score. The analysis was done using SPSS version 20 and STATA version 14.

Result: A total of 632 health facilities were included in the analysis. On average facilities had 63% of tracer items. The overall newborn readiness score for health centres and clinics was lower than that of hospitals. The expected value of newborn care readiness to provide the service was lower in health facilities in Oromiya, Somali and Gambella than facilities in Tigray. In the adjusted model, the type of facility, managing authority and regions were significant. About 74% of the variability of factors associated with newborn care readiness score around its mean was explained.

Conclusion: The availability of four newborn signal functions including neonatal resuscitation, corticosteroids, antibiotics for preterm or prolonged premature rupture of membrane, injectable antibiotics for sepsis, and the readiness of health facilities in terms of the mean availability of ten tracer items to provide the signal functions were low in clinics compared with other facilities. There was a regional variation in the availability of the services. The focus should be given to clinics and regions whose readiness score was low to ensure equity in the distribution of newborn care service capacity.