Assessment of quality of Care in Tikur Anbesa Specialized Teaching Hospital Neonatal Intensive Care Unit, Addis Ababa, Ethiopia
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Date
2015-06
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Addis Abeba Universty
Abstract
Background: Despite the increasing population and unsatisfactory decline of neonatal
mortality rate (NMR) less attention was given to Neonatal Intensive Care Unit (NICU) until
recent years where a little effort is being made to improve the services provided. Currently
there are 27governmental NICUs; Tikur Anbessa Specialized Teaching Hospital (TASTH) is
one of these hospitals which serve as the main referral center. Regardless of the few number
of NICUs there is complaints on the quality of care provided which might be due to a variety
of reasons that are crucial for the survival of the neonates.
Objectives: To assess the quality of care in TASTH, NICU in Addis Ababa, Ethiopia.
Methods: Hospital based cross sectional study was used. The study has two categories of
participants; primarily mother of the neonates who were available in the NICU during the
data collection period and health professionals (n=35) working in the NICU. Sample size of
the study on mothers was calculated using single population formula considering 50%
prevalence which gives a total 384 participants. The unit was observed using inventory
checklist from WHO Hospital Care for Mothers and Newborns: Quality Assessment and
Improvement Tool. For the qualitative portion head of the unit (neonatologist), practicing
neonatologist and the head nurse were included. Structured questionnaire was adopted from
WHO Hospital care for mothers and new-born babies: quality assessment and improvement
tool, and they were filled by the date collectors after obtaining an informed consent. Data was
analyzed using SPSS version 20. P value of 0.05 was the cut off point for the level of
significance. Adjusted odds ratio was used to show strength of association.
Result: The study found that the quality of care that is provided in the neonatal intensive care
unit in TASTH is inadequate. Overall service satisfaction was found to be 96.4% and 47.1%
for the clients and health professionals respectively. Clients whom their neonates shared bed
with others were 6.6 times not satisfied than those clients whom didn’t, AOR (95%CI)
6.612[3.604, 10.109] Health professionals who don’t think that there are a sufficient number
of staffs were dissatisfied 3.15 times compared to those who think the number of staff is
sufficient. AOR (95%CI) 150[0.050, 5.611]
Conclusion and recommendation: Quality administration demands several strategies thus, it
is fundamental to identify the problems, aiming at implementing effective actions, and
monitoring the processes. The findings from this assessment would assist in scaling up of
such units. More over the presence of national guideline which is specific to NICU would be
a key to solve the problems associated with quality of care in NICUs.
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solve the problems associated with quality of care in NICUs.