Background
Improving the quality of newborn care services and accelerating the service utilization of sick young infants (birth-2 months) is required to contribute to the reduction of neonatal mortality in Ethiopia. This study assesses the service utilization and impact on quality care in the primary healthcare units (PHCUs) in West Gojjam zone, Amhara region, Ethiopia.
Methods
A mixed-method approach with a sequential explanatory design was employed in this study. Data was obtained through an interviewer-administered questionnaire to healthcare providers in the PHCUs. Further data was extracted from the sick young infant registers in the PHCUs for a one-year period. Quantitative data was entered in the EpiData 3.1, exported to SPSS and STATA for analysis. Twenty-six participants from the PHCUs were interviewed through focus group discussions. Qualitative data analysis was done manually, and thematic analysis was undertaken.
Results
More than 40% of health facilities were not meeting the quality of case management tasks for sick young infants (SYIs), and the newborn care knowledge of health providers is significantly associated with the quality of sick young infants’ management (P < 0.05). The sick young infants’ service utilization was only 6.3% of the expected sick young infants’ population. The quality of care and service utilization of SYIs are hampered by supply-and demand -side factors namely, inadequately trained healthcare providers, lack of adherence to job-aids, closure of health posts, overburden of HEWs, stock-out of medicines and lack of awareness of sick newborn danger signs, misconceptions on the causes of illnesses and the preference of traditional healers by caregivers.
Conclusion
With the current coverage and quality care of SYIs, the significant reduction of neonatal mortality in the study area might not be achieved. Both supply-and demand-side factors need to be addressed in the PHCUs.