Percent of newborns receiving immediate care according to MOH guidelines
The percent of newborns delivered at a health facility receiving immediate care according to ministry of health (MOH) guidelines.
The clinical standard for the immediate care of newborns includes a physical examination consisting (at a minimum) of the following:
- Vital signs;
- Heart rate;
- Respiratory rate;
- General appearance (e.g., color, malformations, activity level, weight, length, head circumference);
- Gestational age;
- Apgar score; and
- Other interventions (e.g., ophthalmic prophylaxis, vitamin K administration, and completion of the neonatal clinical history).
This indicator is calculated as:
(# of newborns delivered at a facility who receive immediate care according to MOH guidelines / total # of newborns delivered at the facility) x 100
The indicator is calculated for a specific reference period (e.g., per quarter or per year, depending of the size of the facility).
Number of newborns delivered at the facility during the reference period who receive immediate care according to MOH guidelines; the total number of newborns delivered at the facility during the reference period.
If targeting and/or linking to inequity, classify sites by location (poor/not poor) and disaggregate newborns receiving care by location.
Review of medical records; direct observation of providers
Immediate care of the newborn helps identify whether the baby has a normal condition; has a condition or problem requiring urgent, rapid treatment; or has a condition/malformation or other problem that requires transfer to another facility or service. Providing immediate care to newborns helps reduce neonatal complications, sequelae, and deaths.
Physicians and nurses at all levels can learn to systematically perform immediate care for newborns.
The immediate care guidelines can also include specific protocols for identification and treatment of asphyxia, hypothermia, or hypoglycemia.
A low score on this indicator should trigger some intervention(s) to address skills and knowledge of providers, the organization of care, or both. The district health team or facility supervisor can provide support and encouragement to facility staff to ensure compliance with this important standard. Quality improvement teams can also help the facility determine causes for observed difficulties in compliance with the standard, as revealed by the indicator.
For the newborn record to be a reliable data source, staff must fill the record out consistently and accurately. Ideally, the recording form will specify the standards, will facilitate accurate charting, and will stimulate appropriate actions.
quality, newborn (NB)