Table 5 Guidelines for care of preterm, LBW, and sick newborns: challenges and facilitators to provider use
Challenge | Facilitator |
|---|---|
Lack of adequate dissemination; often disseminated to individuals rather than facility units; providers removed guidelines from facility for personal use | Fast dissemination; suggest using schools for dissemination; dissemination to facility units; leaflets and flyers as distribution materials |
Lack of updated guidelines | Timely updates: publication and via internet |
Guidelines did not match well to professional specialty or skill level | Complex cases require guidelines for treatment; Guidelines promotes adherence |
Lack of staff knowledge, which may also have manifested as resistance to policies | Performance monitoring and feedback to staff not using guidelines |
Lack of supplies, equipment, and infrastructure renders guidelines unusable | Equipment provision for the delivery of care |
Lack of periodic professional training | Ongoing training, including in-service |
Staff “too busy” to follow manuals; work overload | |
Lack of relevance to community needs especially at lower-level health facilities |