Table 4 Readiness to provide newborn care and preterm, LBW, and sick newborn care
Facility Unit | Facility Level | Readiness Challenge |
|---|---|---|
Labor and delivery | All | Variable across facility levels and between facility |
Health post | Delivery room not expected nor equipped to provide neonatal service | |
Provided care for emergency patients only; non-emergency patients referred to health center | ||
Lacked qualified providers for newborn care | ||
Health center | Provided care in L&D but only had 1 room and needed more space | |
Provided the service at the time needed but space and comfort were inadequate | ||
Equipped for neonatal care and for preterm, LBW, and sick newborns, but health center rarely encountered them | ||
Served routine-care neonates but not preterm, LBW, and sick newborns; no materials or specialized provider | ||
Had laboratory technician and new rooms but lacked additional professionals | ||
Prepared, but preterm, LBW, and sick newborns transferred to under-5 department or hospital as needed | ||
Space limitations prohibited neonatal care in L&D | ||
Inadequate supplies, services, and space for preterm, LBW, and sick newborn care | ||
Hospital | Not enough training for L&D providers to give proper neonatal care | |
May not have had space for neonates or proper equipment to give care | ||
Hospital staff was ready but lacked ventilator | ||
Hospital lacked space and beds; could not accommodate newborns | ||
Lack of infrastructure, equipment, and food for patients hindered abilities | ||
L&D rooms lacked handwashing stations | ||
NICU | All | Most respondents reported no NICU; no expectation for that to change |
Health post | Never expected | |
Health center | No NICU | |
Hospital | Needed supplies and additional providers | |
Needed space for parents; no place for them to wait or sleep | ||
Material shortage, including of medication and equipment | ||
NICU isolated; parents could look through glass; mother could visit if baby improved; when no water to clean gowns, parents could not enter NICU | ||
KMC | All | Adequate in many facilities; most offered KMC even if referring up |
Health post | KMC service provided prior to referral to health center | |
Space may be just a corner or nook or no space at all | ||
Health center | No separate room; KMC in L&D or pediatrics; little space with no food storage | |
Hospital | KMC and NICU joined in this hospital; sophisticated care available, including water and toilet | |
KMC room available for dyads when mother was healthy; when mother admitted, baby stayed in KMC without parent | ||
Inpatient ward | Health post | Never expected |
Health center | None; accommodated elsewhere in facility | |
Hospital | Facility with NICU could care for preterm, LBW, and sick newborns; budgets may not have covered basics like diapers, clothes, or even necessary treatment for preterm, LBW, and sick newborns |