Assessing the Readiness of the Newborn Unit at Kenyatta National Hospital to Implement Nurturing Care Practices for Preterm Infants

Abstract

Background: Low- and middle-income countries (LMICs) are lagging behind in addressing the problem of neonatal mortality even though marked reductions in global mortality rates have occurred in the last two decades. The WHO and UNICEF report of 2019 places the current burden of neonatal deaths at 2.4 million per year, 80% of which are preterm births from LMICs. Reducing deaths and morbidity among preterm babies is thus a priority. The nurturing care framework is one of the main approaches proposed to mitigate these concerns. Aim: This situational analysis aimed to assess the readiness of the newborn unit (NBU) at Kenyatta National Hospital (KNH) to effectively implement a nurturing care program meant to reduce infant morbidity and mortality in preterm newborns. Methodology: The situational analysis was a convergent parallel mixed-methods study. Quantitative data was collected using a nurturing care checklist while qualitative data was collected using interview questions derived from the Service availability and readiness assessment (SARA) survey questions. Convenience sampling guided by the grounded theory was used to recruit participants. The target population comprised clinical providers working at the NBU of KNH. Demographic and the nurturing care checklist data were analyzed quantitatively by summarizing the descriptive data using proportions. Interview responses to the questions from SARA survey were analyzed thematically to assess clinical providers’ perspectives on newborn unit’s readiness to embrace nurturing care. Results: The NBU at KNH has the infrastructure, human resources, and supplies needed to provide nurturing care to preterm infants but it needs more to cater for the high admission rates that exceed the NBU’s capacity. It lacks dedicated nurturing care policies, guidelines, and protocols. The training of healthcare professionals and education of patients regarding 2 nurturing care should be formalized and structured for comprehensiveness. The delivery of nurturing care in the NBU is derailed by barriers such as interruptions in medical supplies, lack of structures, and inadequate staffing. Conclusion: The NBU at KNH is implementing nurturing care in piecemeal. It has the capacity to implement nurturing care comprehensively. It can establish the necessary policies, guidelines and protocols; hire additional nurses and doctors, streamline the procurement of medical supplies and nutritional products, and create formal training programs on nurturing care as well as address other barriers to successfully implement nurturing care