Mothers’ Opinion About the Quality of New-Born Health Services: Implementation Research in Nampula, Mozambique

Abstract

Background: New-born mortality is high in Africa, including in Mozambique (67.3 deaths of children less than one year of age per 1000 live births, 2017). One important factor to reduce this public health burden is ensuring the frequency and quality of newborn visits, with the availability of effectively and timely patient centred care. To reduce the new-born mortality rate in Natikiri, Nampula, teams of researchers from Lúrio University, Mozambique and the University of Saskatchewan, Canada, carried out implementation research, Alert Community for a Prepared Hospital care continuum, which included training programs for health professionals in maternal and child health care as a central component. We planned a mid-project evaluation, to assess the impact of these trainings on the quality of new-born care services at Marrere Health Centre. Methods: This was a quantitative study, applying two cross-sectional surveys about new-born visits quality at the Marrere Health Centre in Natikiri district, on the outskirts of Nampula city in Nampula province, northern Mozambique. The first survey was conducted after two health professional training sessions and the other after five more sessions. The samples of carers of infants up to 28 days of age were surveyed at the Healthy Child Service, Child at Risk Service and Emergency Room, and were calculated considering the average number of post-partum visits per month, 47 in 2018, using a margin of error of 10% and a confidence interval of 90%, and 134 in 2019, using a margin of error of 5% and a confidence interval of 95%. The surveys included a wide variety of user opinion measures of quality and used a five-point Likert scale; the responses were coded and entered REDCap digital database, and analysed to assess frequencies, percentages, mean and standard deviations. This research was approved by the bioethics committees at both Lúrio University and at the University of Saskatchewan. Results: 188 mothers were surveyed at Marrere Health Centre, about the quality of new-born services they had just received. Most areas of childcare services showed no improvement with the trainings. Positive improvements were a 48% increase in health professionals encouraging mothers to share any difficulties during the visit, and a 31% increase in encouraging mothers to have a person of their choice to accompany them during labour, almost always suggesting a traditional birth attendant (97%). Many Citation: Pires P, Mupueleque M, Mucufo JR, Zakus D, Siemens R, et al. (2021) Mothers’ Opinion About the Quality of New-Born Health Services: Implementation Research in Nampula, Mozambique. Arch Pediatr 6: 195. DOI: 10.29011/2575-825X.100095 2 Volume 6; Issue 01 Arch Pediatr, an open access journal ISSN: 2575-825X shortcomings persisted in practices of introducing themselves, communication with patients, privacy, and confidentiality. Conclusion: The quality of care at Marrere Health Centre’ new-born health services did not improve after an earnest attempt at building capacity of the health professionals in the hope of improving practice. We learned that they fell short of practising according to Ministry of Health protocol and did not adopt the key training messages, which had been reinforced through role playing. Reviewing the learning approaches and developing a program of continuous capacity building would be the next steps to further try to improve quality of new-born care.