Maria Asuncion A Silvestre1, Priya Mannava2, Marie Ann Corsino1,3, Donna S Capili1, Anthony P Calibo4, Cynthia Fernandez Tan5, John C S Murray2, Jacqueline Kitong6, Howard L Sobel2. 1. Kalusugan ng Mag-Ina, Inc. (KMI; Health of Mother and Child), Quezon City, Philippines. 2. Reproductive, Maternal, Newborn, Child and Adolescent Health Unit, World Health Organization Western Pacific Regional Office, Manila, Philippines. 3. Department of Pediatrics, Remedios Trinidad Romualdez Medical Foundation, Tacloban City, Philippines. 4. Family Health Office, Disease Prevention and Control Bureau, Department of Health, Manila, Philippines. 5. Dr Jose Fabella Memorial Hospital, Manila, Philippines. 6. Reproductive, Maternal, Newborn, Child and Adolescent Health, Office of the World Health Organization Representative in the Philippines, Manila, Philippines.
Abstract
OBJECTIVE: To determine whether intrapartum and newborn care practices improved in 11 large hospitals between 2008 and 2015. DESIGN: Secondary data analysis of observational assessments conducted in 11 hospitals in 2008 and 2015. SETTING: Eleven large government hospitals from five regions in the Philippines. PARTICIPANTS: One hundred and seven randomly sampled postpartum mother-baby pairs in 2008 and 106 randomly sampled postpartum mothers prior to discharge from hospitals after delivery. INTERVENTIONS: A national initiative to improve quality of newborn care starting in 2009 through development of a standard package of intrapartum and newborn care services, practice-based training, formation of multidisciplinary hospital working groups, and regular assessments and meetings in hospitals to identify actions to improve practices, policies and environments. Quality improvement was supported by policy development, health financing packages, health facility standards, capacity building and health communication. MAIN OUTCOME MEASURES: Sixteen intrapartum and newborn care practices. RESULTS: Between 2008 and 2015, initiation of drying within 5 s of birth, delayed cord clamping, dry cord care, uninterrupted skin-to-skin contact, timing and duration of the initial breastfeed, and bathing deferred until 6 h after birth all vastly improved (P<0.001). The proportion of newborns receiving hygienic cord handling and the hepatitis B birth dose decreased by 11-12%. Except for reduced induction of labor, inappropriate maternal care practices persisted. CONCLUSIONS: Newborn care practices have vastly improved through an approach focused on improving hospital policies, environments and health worker practices. Maternal care practices remain outdated largely due to the ineffective didactic training approaches adopted for maternal care.
OBJECTIVE: To determine whether intrapartum and newborn care practices improved in 11 large hospitals between 2008 and 2015. DESIGN: Secondary data analysis of observational assessments conducted in 11 hospitals in 2008 and 2015. SETTING: Eleven large government hospitals from five regions in the Philippines. PARTICIPANTS: One hundred and seven randomly sampled postpartum mother-baby pairs in 2008 and 106 randomly sampled postpartum mothers prior to discharge from hospitals after delivery. INTERVENTIONS: A national initiative to improve quality of newborn care starting in 2009 through development of a standard package of intrapartum and newborn care services, practice-based training, formation of multidisciplinary hospital working groups, and regular assessments and meetings in hospitals to identify actions to improve practices, policies and environments. Quality improvement was supported by policy development, health financing packages, health facility standards, capacity building and health communication. MAIN OUTCOME MEASURES: Sixteen intrapartum and newborn care practices. RESULTS: Between 2008 and 2015, initiation of drying within 5 s of birth, delayed cord clamping, dry cord care, uninterrupted skin-to-skin contact, timing and duration of the initial breastfeed, and bathing deferred until 6 h after birth all vastly improved (P<0.001). The proportion of newborns receiving hygienic cord handling and the hepatitis B birth dose decreased by 11-12%. Except for reduced induction of labor, inappropriate maternal care practices persisted. CONCLUSIONS: Newborn care practices have vastly improved through an approach focused on improving hospital policies, environments and health worker practices. Maternal care practices remain outdated largely due to the ineffective didactic training approaches adopted for maternal care.
Authors: Hoang Thi Tran; Priya Mannava; John C S Murray; Phuong Thi Thu Nguyen; Le Thi Mong Tuyen; Tuan Hoang Anh; Thi Quynh Nga Pham; Vinh Nguyen Duc; Howard L Sobel Journal: EClinicalMedicine Date: 2019-01-14
Authors: Zhao Li; Priya Mannava; John Charles Scott Murray; Howard Lawrence Sobel; Annie Jatobatu; Anthony Calibo; Baldan Tsevelmaa; Bounnack Saysanasongkham; Divinal Ogaoga; Edward Joseph Waramin; Elizabeth Mary Mason; Hiromi Obara; Hoang Thi Tran; Hoang Anh Tuan; Jacqueline Kitong; Jessica Mara Yaipupu; Kannitha Cheang; Maria Asuncion Silvestre; Outhevanh Kounnavongsa; Pamela Putney; Pham Thi Quynh Nga; Rathavy Tung; Sano Phal; Shogo Kubota; Sidonn Krang; Simon Burggraaf; Sommana Rattana; Tao Xu; Tuohong Zhang; Ulziikhutag Enkhmaa; Vanya Delgermaa; Y Meng Chhour Journal: BMJ Glob Health Date: 2020-08
Authors: Hoang Thi Tran; Tuan T Nguyen; Hoang Thi Nam Giang; Le Thi Huynh; Debbie Barnett; Roger Mathisen; John C S Murray Journal: Nutrients Date: 2021-03-31 Impact factor: 5.717