Evidence-based training and mentorship combined with enhanced outcomes surveillance to address the leading causes of neonatal mortality at the district hospital level in Ghana

Mary N A Brantuo, Elizabeth Cristofalo, Mira M. Meheš, Juliana Ameh, Nana Okai Brako, Frederick Boahene, Stella B. Adjei, Ernest Opoku, Harriet Banda, Yu T. Wang, Abdulai A. Forgor, Damien Punguire, Kennedy Brightson, Cynthia Sottie, Seth Owusu-Agyei, John E. Williams, Abubakari Sulemana, Abraham R. Oduro, Margaret Gyampong, Doris SarpongEdith Andrews, Martha Gyansa-Lutterodt, Abraham Hodgson, Cynthia Bannerman, Fizan Abdullah*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Objective: To evaluate the impact of a district hospital intervention focused on enhancing healthcare provider capacity to address leading causes of neonatal death: birth asphyxia, infection and prematurity. Methods: The neonatal quality improvement initiative was launched at two intervention referral district hospitals in Ghana. Local Health and Demographic Surveillance Systems were enlisted to enhance recording of neonatal and infant deaths in the community and at the facility. After baseline site assessments, a team of local paediatric experts conducted three clinical trainings on-site at each intervention hospital. Assessments were conducted to evaluate participant knowledge before and after participation in training modules. Monthly mentorship visits provided additional training to support the adoption of essential early neonatal care practices. Results: In the first year of implementation, the initiative provided focused clinical training to 278 participants. A comparison of pre- and post-training test results demonstrates significant improvement in provider knowledge (73% vs. 89% correct, P < 0.001), with even greater improvement among trainees receiving recurrent refresher training (86% vs. 94% correct, P < 0.001). Participant feedback following training revealed enthusiasm about the programme and improved confidence. Conclusions: Locally led initiatives that invest directly in healthcare provider education and health systems strengthening represent a promising avenue for reducing neonatal morbidity and mortality. The NQI initiative demonstrates the positive impact of a district hospital intervention that combines on-site training, mentorship and enhanced demographic surveillance.

Original languageEnglish (US)
Pages (from-to)417-426
Number of pages10
JournalTropical Medicine and International Health
Volume19
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • District hospitals
  • Evidence-based
  • Ghana
  • Mentorship
  • Neonatal mortality
  • Training

ASJC Scopus subject areas

  • Parasitology
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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