The Availability and Quality of Continuous Positive Airway Pressure (CPAP) for Neonatal Care in Public Health Facilities in India: A Cross- Sectional Cluster Survey

2018 ◽  
Author(s):  
Juan Emmanuel Dewez ◽  
Sushma Nangia ◽  
Harish Chellani ◽  
Sarah White ◽  
Paul Francis ◽  
...  
Keyword(s):  
Public Health ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Neonatal Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Cluster Survey ◽  
Public Health Facilities

scholarly journals Availability and use of continuous positive airway pressure (CPAP) for neonatal care in public health facilities in India: a cross-sectional cluster survey

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031128
Author(s):  
Juan Emmanuel Dewez ◽  
Sushma Nangia ◽  
Harish Chellani ◽  
Sarah White ◽  
Matthews Mathai ◽  
...  
Keyword(s):  
Continuous Positive Airway Pressure ◽  
Representative Sample ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Case Fatality ◽  
Neonatal Care ◽  
Complication Rates ◽  
Cross Sectional ◽  
Cluster Survey ◽  
Government Hospitals

ObjectivesTo determine the availability of continuous positive airway pressure (CPAP) and to provide an overview of its use in neonatal units in government hospitals across India.SettingCross-sectional cluster survey of a nationally representative sample of government hospitals from across India.Primary outcomesAvailability of CPAP in neonatal units.Secondary outcomesProportion of hospitals where infrastructure and processes to provide CPAP are available. Case fatality rates and complication rates of neonates treated with CPAP.ResultsAmong 661 of 694 government hospitals with neonatal units that provided information on availability of CPAP for neonatal care, 68.3% of medical college hospitals (MCH) and 36.6% of district hospitals (DH) used CPAP in neonates. Assessment of a representative sample of 142 hospitals (79 MCH and 63 DH) showed that air-oxygen blenders were available in 50.7% (95% CI 41.4% to 60.9%) and staff trained in the use of CPAP were present in 56.0% (45.8% to 65.8%) of hospitals. The nurse to patient ratio was 7.3 (6.4 to 8.5) in MCH and 6.6 (5.5 to 8.3) in DH. Clinical guidelines were available in 31.0% of hospitals (22.2% to 41.4%). Upper oxygen saturation limits of above 94% were used in 72% (59.8% to 81.6%) of MCH and 59.3% (44.6% to 72.5%) of DH. Respiratory circuits were reused in 53.8% (42.3% to 63.9%) of hospitals. Case fatality rate for neonates treated with CPAP was 21.4% (16.6% to 26.2%); complication rates were 0.7% (0.2% to 1.2%) for pneumothorax, 7.4% (0.9% to 13.9%) for retinopathy and 1.4% (0.7% to 2.1%) for bronchopulmonary dysplasia.ConclusionsCPAP is used in neonatal units across government hospitals in India. Neonates may be overexposed to oxygen as the means to detect and treat consequences of oxygen toxicity are insufficient. Neonates may also be exposed to nosocomial infections by reuse of disposables. Case fatality rates for neonates receiving CPAP are high. Complications might be under-reported. Support to infrastructure, training, guidelines implementation and staffing are needed to improve CPAP use.

scholarly journals Level of Quality of Option B+PMTCT Service Provision in Public Health Facilities in Mekelle Zone, Northern Ethiopia: Cross-sectional study

2019 ◽  
Author(s):  
Kiros Fenta Ajemu ◽  
Alem Desta
Keyword(s):  
Public Health ◽  
Maternal Health Services ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Northern Ethiopia ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Output Quality

Abstract Background Substantial improvements have been observed in coverage and access to maternal health services in Ethiopia. However, quality of care has been lagging behind. Therefore, the aim of the study was to assess quality of OptionB + in Mekelle Zone, Northern Ethiopia.Methods Facility based cross-sectional study involving both quantitative and qualitative methods was conducted from December 2016- January 2017. The quality of service delivery was assessed in 11 public health facilities in Mekelle. Data collection was conducted using facility audit, observation, and client exit interview check list to assess (Input-Process–Output) quality components. Similarly in-depth interview guide was used to gather qualitative data. Data were analyzed using SPSS version 21 software. Descriptive statistics were computed to summarize the study findings and triangulation was made with qualitative findings.Results Overall, 2 (16.7%) of study health facilities full filled all the three quality components but none in 3(25%). The input quality component was better than the others in which 4(33.3%) facilities were rated as good. The process and output quality components were judged as good in 3(25%) study health facilities.Conclusion Only 16.7% of facilities studied were achieved good quality with respect to the three predetermined quality components. Since, assessed items in each quality component were potentially easy to intervene; strengthening program monitoring needed by program managers at each level of the health facilities.

scholarly journals Quality of essential newborn care and neonatal resuscitation at health facilities in Afghanistan: a cross-sectional assessment

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030496
Author(s):  
Faridullah Atiqzai ◽  
Partamin Manalai ◽  
Sher Shah Amin ◽  
Karen M Edmond ◽  
Malalai Naziri ◽  
...  
Keyword(s):  
Public Health ◽  
Neonatal Resuscitation ◽  
Newborn Care ◽  
High Volume ◽  
Health Facilities ◽  
Cross Sectional ◽  
Essential Newborn Care ◽  
Public Health Facilities ◽  
Skin Contact

ObjectiveTo assess readiness and quality of essential newborn care and neonatal resuscitation practices in public health facilities in Afghanistan.DesignCross-sectional assessment.Setting226 public health facilities in Afghanistan, including 77 public health facilities with at least five births per day (high-volume facilities) and 149 of 1736 public health facilities with fewer than five births per day (low-volume facilities).ParticipantsManagers of 226 public health facilities, 734 skilled birth attendants (SBAs) working at these facilities, and 643 women and their newborns observed during childbirth at 77 high-volume health facilities.Outcome measuresAvailability of knowledgeable SBAs, availability of supplies and compliance with global guidelines for essential newborn care and neonatal resuscitation practices.ResultsAt high-volume facilities, 569/636 (87.9%) of babies were dried immediately after birth, 313/636 (49.2%) were placed in skin-to-skin contact with their mother and 581/636 (89.7%) had their umbilical cord cut with a sterile blade or scissors. A total of 87 newborn resuscitation attempts were observed. Twenty-four of the 87 (27.5%) began to breath or cry after simply clearing the airway or on stimulation. In the remaining 63 (72.5%) cases, a healthcare worker began resuscitation with a bag and mask; however, only 54 (62%) used a correct size of mask and three babies died as their resuscitation with bag and mask was unsuccessful.ConclusionsThe study indicates room for improvement of the quality of neonatal resuscitation practices at public health facilities in Afghanistan, requiring only strengthening of the current best practices in newborn care. Certain basic and effective aspects of essential newborn care that can be improved on with little additional resources were also missing, such as skin-to-skin contact of the babies with their mother. Improvement of compliance with the standard newborn care practices must be ensured to reduce preventable newborn mortality and morbidity in Afghanistan.

scholarly journals Quality of Drug in Health Facilities: A Cross-sectional Study

2021 ◽  
Vol 18 (4) ◽  
pp. 644-648
Author(s):  
Khem Bahadur Karki ◽  
Neelam Dhakal ◽  
Baburam Humagain ◽  
Arpana Pandit ◽  
Trishna Acharya ◽  
...  
Keyword(s):  
Public Health ◽  
Storage Condition ◽  
Cross Sectional Study ◽  
Poor Quality ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Health Facilities

Background: Poor quality drugs result minor to detrimental effect on human health. The drug should be of standard quality and should be used appropriately in order to meet its therapeutic efficacy. This study aims to assess the quality of drug in Nepal. Methods: A cross sectional study was conducted in randomly selected 88 health facilities in Nepal from 10th April to 30th June 2016. Selective medicines were collected from both private licensed pharmacies and selected public health facilities. Face to face interview with health facility in-charge of selected health facilities was carried out along with the direct observation of the medicine storage room. The collected medicine samples were dispatched to two laboratories for in-vitro analysis. The labels of the collected medicine were analyzed. The obtained data were entered in Epidata version 3.1, cleaned in Microsoft excel 2007 and analyzed in SPSS version 20.Results: Out of 172 brands, nine brands of medicines were found substandard. Information regarding storage conditions, direction for use and category of the drug were lacking in the label of some brands of medicines. Some selected health facilities were found not meeting major requirements for drug storage: protection from sunlight, moisture, heat, well ventilation and proper sanitation.Conclusions: Few drugs were found to be substandard in Nepalese market from both public and private sectors. Adequate labeling and proper storage condition of medicines in health facilities were lacking.Keywords: Drug quality; private pharmacies; public health facilities; substandard drugs.

scholarly journals Quality of Medical Records in Public Health Facilities of Jimma Zone, Oromia Regional State, Southwest, Ethiopia 2021

2021 ◽  
Author(s):  
Nigusu Endashaw ◽  
Bezawit Birhanu ◽  
Melese Teka ◽  
Gelila Abrham
Keyword(s):  
Public Health ◽  
Medical Records ◽  
Quantitative Data ◽  
Health Facilities ◽  
Health Centers ◽  
Cross Sectional ◽  
Southwest Ethiopia ◽  
Public Health Facilities ◽  
Jimma Zone

Abstract Background: Comprehensive medical records are cornerstones in the quality and efficiency of patient care, as they can provide a complete and accurate chronology of treatments, patient results, and future plans for care. The study was aimed to assess the quality of medical records in public health facilities of Jimma Zone. Methods: A facility-based cross-sectional quantitative study design supplemented by a qualitative method was used from May 30 to July 29, 2020. A total of 384 medical records were reviewed by using the facility inventory form for quantitative data. The data was entered by EPI data 3.1 and analyzed by SPSS 23 and descriptive statistics were used to present the findings. Qualitative data were triangulated with the quantitative data.Result: The majority of the health facility has a shortage of trained and qualified recording personnel in the medical record department. Among 36 health facilities, only one facility have printer in the record room and 3(8%) of them have tracer card. The overall quality of medical records in terms of content completeness as per the standard of health facilities requirements for districts, hospitals, and health centers were 30.62%, 39.49%, 25.79% respectively. Conclusion: The majority of medical records had poor completeness of administrative data, clinical, financial, and legal contents. The overall quality of medical records in Jimma Zone was very low for components of the quality of medical records as per the standard of health facilities requirements.

scholarly journals Quality of malaria services offered in public health facilities in three provinces of Mozambique: a cross-sectional study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Baltazar Candrinho ◽  
Mateusz M. Plucinski ◽  
James M. Colborn ◽  
Mariana da Silva ◽  
Guidion Mathe ◽  
...  
Keyword(s):  
Public Health ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
Sectional Study ◽  
Cross Sectional ◽  
Public Health Facilities

scholarly journals Alternatives to continuous positive airway pressure treatment in sleep apnoeas and hypopnoeas syndrome related to myofunctional and postural reeducation therapy: protocol for a systematic review

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049286
Author(s):  
Marta Maria Guijarro-Herráiz ◽  
Natalia María Arias-Palencia ◽  
Lidia Lucas- de la Cruz ◽  
Beatriz Guijarro-Herráiz ◽  
Blanca Notario-Pacheco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Continuous Positive Airway Pressure ◽  
Airway Pressure ◽  
Positive Airway Pressure ◽  
Meta Analysis ◽  
Treatment Protocol ◽  
Cross Sectional ◽  
New Treatments

IntroductionThe main treatment for sleep apnoeas and hypopnoeas syndrome (SAHS) is continuous positive airway pressure (CPAP). However, patients sometimes do not adhere to the treatment protocol. Supplementary and complementary therapies have appeared as alternatives. Some of the therapies which are especially important are those related to myofunctional (MFT) and postural therapy (PT), as all of them are non-invasive, and their application is simpler than that of CPAP. We aim to present a protocol for a systematic review and meta-analysis for investigating new SAHS treatments, including the protocols and frequency of use and the effects they have on patient signs, symptoms and quality of life.Methods and analysisThe literature search will be conducted using the Cochrane, Web of Science, Medline (via PubMed) and Scopus databases, from January 2020 to December 2020. All types of studies written in English and Spanish that investigate the use of alternative SAHS treatments related to MFT, or more importantly, the combination of MFT and PRT, will be selected. To evaluate their quality, the Critical Appraisal Checklist for Analytical Cross-Sectional will be applied. The primary factor valued in the studies will be the inclusion of MFT and PT reeducation in the treatment. Subgroup analyses will be carried out evaluating the specific type of treatments chosen and the improvements or deteriorations in the level of health and quality of life in the patients. Finally, several patient-related outcomes, namely sleep quality, quality of life and sleep Apnoeas and Hypoapnoeas Index, will be examined.Ethics and disseminationIn this case, ethical approval is not necessary. The data used in the review will be exclusively obtained from published studies, implying there are no privacy concerns. The information obtained will be relevant to understand if the new treatments applied in SAHS are effective, and if postural and MFT therapy used together can be considered an appropriate approach to treat this disease.The results will be published in a peer-reviewed journal.

scholarly journals Performance of primary care in different healthcare facilities: a cross-sectional study of patients’ experiences in Southern Malawi

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029579
Author(s):  
Luckson Dullie ◽  
Eivind Meland ◽  
Øystein Hetlevik ◽  
Thomas Mildestvedt ◽  
Stephen Kasenda ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Facilities ◽  
Cross Sectional ◽  
Public Health Facilities ◽  
Quality Of Primary Care ◽  
Care Assessment ◽  
Health Centres ◽  
Care Performance

ObjectiveIn most African countries, primary care is delivered through a district health system. Many factors, including staffing levels, staff experience, availability of equipment and facility management, affect the quality of primary care between and within countries. The purpose of this study was to assess the quality of primary care in different types of public health facilities in Southern Malawi.Study designThis was a cross-sectional quantitative study.SettingThe study was conducted in 12 public primary care facilities in Neno, Blantyre and Thyolo districts in July 2018.ParticipantsPatients aged ≥18 years, excluding the severely ill, were selected to participate in the study.Primary outcomesWe used the Malawian primary care assessment tool to conduct face-to-face interviews. Analysis of variance at 0.05 significance level was performed to compare primary care dimension means and total primary care scores. Linear regression models at 95% CI were used to assess associations between primary care dimension scores, patients’ characteristics and healthcare setting.ResultsThe final number of respondents was 962 representing 96.1% response rate. Patients in Neno hospitals scored 3.77 points higher than those in Thyolo health centres, and 2.87 higher than those in Blantyre health centres in total primary care performance. Primary care performance in health centres and in hospital clinics was similar in Neno (20.9 vs 19.0, p=0.608) while in Thyolo, it was higher at the hospital than at the health centres (19.9 vs 15.2, p<0.001). Urban and rural facilities showed a similar pattern of performance.ConclusionThese results showed considerable variation in experiences among primary care users in the public health facilities in Malawi. Factors such as funding, policy and clinic-level interventions influence patients’ reports of primary care performance. These factors should be further examined in longitudinal and experimental settings.

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