Practices of and Barriers to Essential Newborn Care Among Nurses in Tertiary Hospitals in Bangladesh.

Abstract

Objective: To investigate the practices of nurses and related barriers regarding essential newborn care in tertiary hospitals.

Design: Cross-sectional study.

Setting: M. Abdur Rahim Medical College Hospital and Rangpur Medical College Hospital.

Participants: Three hundred seventy-nine nurses.

Methods: Data were collected using convenience sampling techniques. The study period was from January 1 through December 31, 2023. The association between two categorical variables was determined by chi-square test and Fisher's exact test. A p < .05 was considered significant.

Results: Of 379 respondents, 95.5% were female, 81.8% were Muslim, and 78.6% were married. In terms of professional qualifications, 72.8% held a diploma in nursing and 27.2% were pursuing graduation and above. Regarding work experience, 40.9% of respondents (n = 155) were novices, 25.1% (n = 95) were advanced beginners, 21.1% (n = 80) were competent, 12.1% (n = 46) were proficient, and 0.8% (n = 3) were experts. High adherence was observed for thermal care and cord care, and lower adherence occurred for Apgar scoring (62.3%), application of tetracycline eye ointment (51.5%), and handwashing counseling (77.6%). Approximately two thirds of the respondents (n = 252) demonstrated a good level of practice. Good practice was significantly and positively associated with female gender (p < .001), higher education level (p < .001), and increasing work experience (p < .040). Commonly reported barriers included staffing shortages (86.0%), poor work environment (85.2%), inadequate equipment (79.4%), insufficient medicines (80.2%), communication gaps (83.9%), and lack of training (66.2%). Several barriers, including lack of training, inadequate supplies, and communication gaps, were significantly associated with poorer practice.

Conclusion: Despite generally good essential newborn care practices, critical gaps persist. Improving training, strengthening resources, and addressing organizational challenges are essential to enhance neonatal health outcomes in Bangladesh.