Factors associated with the implementation of helping babies breathe guidelines among skilled birth attendants in health facilities in Dar-es-salaam

Abstract

ABSTRACT Background: The practice of Helping Babies Breathe (HBB) reduces neonatal death due to birth asphyxia. Globally each year, birth asphyxia results in 1.2 million stillbirths, also it is approximated that 10 million babies cannot take breathe by themselves and need assistance, therefore, all skilled birth attendants (SBAs), including physicians, midwives and nurses ought to be trained on HBB in order to equip them with competences required in initial neonatal resuscitation. Broad objective: To determine factors associated with the implementation of HBB guidelines adherence in initial newborn resuscitation among SBAs working in maternity units in health facilities in Dar-es-Salaam region. Materials and Method: A descriptive cross-sectional study design was applied and the study took place in five selected health facilities; Amana, Temeke, Mwananyamala, TMJ and Kairuki hospitals in Dar-es- Salaam region. The study population was nurses and midwives working in maternity units (labour, antenatal and postnatal wards) with the sample size of 133, out of whom 132 responded to the questionnaires. Probability proportional sampling was used to select participants from five selected health facilities and from each health facility; the participants obtained using convenient sampling. Data collected by using pre-tested self administered questionnaires and were analyzed using SPSS version 25. The associations between variables tested by using, frequency distribution, Chi square test and logistic regression. Results: The majority of respondents 54(40.9%) had the age between 26 and 35, married 89(67.4%), female 112(84.8%) and had completed the certificate level of education 54(40.9%). Most of BAs were working in the labor ward 56(42.4%). Of the 132 respondents, 83.3% (n=110) were trained on the HBB. However, 45(34.1%) adhere to guideline in initial newborn resuscitation. Training on HBB (P value 0.049), documentation of HBB resuscitation outcome (P value 0.025) and integration of HBB to EmONC (P value 0.028) had shown significant association with adherence to the guideline by multivariate analysis. Conclusion: HBB guideline adherence in initial newborn resuscitation depends largely on training of all SBAs and proper documentation of HBB resuscitation outcome. To improve the outcomes of resuscitated babies, we need well-experienced Birth Attendants who are competent and confident in performing neonatal resuscitation during golden minute.