Factors Associated with Knowledge and Practice of Essential Newborn Care among Nurse-Midwives at Amana, Mwananyamala and Temeke Regional Hospitals in Dar Es Salaam, Tanzania

Abstract

Background: Tanzania is among the Sub-Saharan country in Africa with high rates of neonatal mortality. Neonatal deaths occur due to obstetric and newborn complications and mainly due to limited access to essential newborn care (ENC) services which every newborn needs to receive for survival. ENC prevents greatly the newborn morbidity and mortality. Regardless of its importance, ENC has been neglected in low and middleincome countries. Aim: The aim of this study was to assess factors associated with knowledge and practice of essential newborn care among Nurse-Midwives at referral hospitals in Dar es Salaam. Methods: This was descriptive cross-sectional study conducted at Temeke, Amana and Mwananyamala regional hospitals in Dar es Salaam. An interview administered questionnaire was used to collect data. Data analysis was done with help of Stata version 13.0. Both bivariate and multivariate analyses were employed to determine associations between independent variables and study outcomes. A (95%) confidence index was used to measure statistical association. Results: The mean age of the 112 nurse-midwives who participated in this study was 36.4 years with standard deviation of 8.2 years. Overall, 53% of nurse midwives had adequate knowledge of essential newborn Care (ENC) and 56% had adequate practice of ENC. Factors associated with knowledge of ENC among Nurse-Midwives included availability of ENC guidelines [AOR=11.69, 95%CI: (1.81-75.61), P=0.010] and regular training of ENC [AOR=4.04; 95%CI: (1.40-11.64), P=0.010]. However, in the multivariate analysis, on job training on ENC in the past two years [AOR=2.99, 95%CI: (1.11-8.10), P=0.031] and availability of ENC guidelines had strong association with ENC practice [AOR=3.78, 95%CI (0.67-21.47), P=0.133]. Conclusion: Findings of this study showed that on-job training and availability of ENC guidelines were significantly associated with knowledge and practice of ENC. Other factors which had positive association with provision of ENC were high education level, greater age, working in labour ward and obstetrics theatre. To ensure effective provision of ENC by Nurse-Midwives, Ministry of health in collaboration with health facilities should ensure availability of ENC guidelines to facilitate provision of ENC and conduct regular training of ENC to improve knowledge and practice of ENC among Nurse-Midwives.