title: Are hospitals prepared to support newborn survival? - An evaluation of eight first-referral level hospitals in Kenya.
abstract: OBJECTIVE
  To assess the availability of resources that support the provision of basic neonatal care in eight first-referral level (district) hospitals in Kenya.
  
  
  METHODS
  We selected two hospitals each from four of Kenya's eight provinces with the aim of representing the diversity of this part of the health system in Kenya. We created a checklist of 53 indicator items necessary for providing essential basic care to newborns and assessed their availability at each of the eight hospitals by direct observation, and then compared our observations with the opinions of health workers providing care to newborns on recent availability for some items, using a self-administered structured questionnaire.
  
  
  RESULTS
  The hospitals surveyed were often unable to maintain a safe hygienic environment for patients and health care workers; staffing was insufficient and sometimes poorly organised to support the provision of care; some key equipment, laboratory tests, drugs and consumables were not available while patient management guidelines were missing in all sites.
  
  
  CONCLUSIONS
  Hospitals appear relatively poorly prepared to fill their proposed role in ensuring newborn survival. More effective interventions are needed to improve them to meet the special needs of this at-risk group.
authors.affiliation: KEMRI Centre for Geographic Medicine Research - Coast, and Wellcome Trust Research Programme, Nairobi, Kenya. copondo@nairobi.kemri-wellcome.org
authors.forename: Charles
authors.initials: C
authors.lastname: Opondo
authors.forename: Stephen
authors.initials: S
authors.lastname: Ntoburi
authors.forename: John
authors.initials: J
authors.lastname: Wagai
authors.forename: Jackline
authors.initials: J
authors.lastname: Wafula
authors.forename: Aggrey
authors.initials: A
authors.lastname: Wasunna
authors.forename: Fred
authors.initials: F
authors.lastname: Were
authors.forename: Annah
authors.initials: A
authors.lastname: Wamae
authors.forename: Santau
authors.initials: S
authors.lastname: Migiro
authors.forename: Grace
authors.initials: G
authors.lastname: Irimu
authors.forename: Mike
authors.initials: M
authors.lastname: English
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence / Q000592:standards*; D005260:Female; D006272:Health Facility Environment / Q000592:standards*; D006801:Humans; D007231:Infant, Newborn; D007630:Kenya; D008297:Male; D008430:Maternal-Child Health Centers / Q000592:standards*; D020380:Needs Assessment; D017410:Practice Guidelines as Topic / Q000592:standards*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011787:Quality of Health Care / Q000592:standards*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
references.citation: Lancet. 2005 Mar 5-11;365(9462):891-900
references.pmid: 15752534
references.citation: Soc Sci Med. 1995 Jul;41(1):87-98
references.pmid: 7667676
references.citation: Implement Sci. 2009 Jul 23;4:42
references.pmid: 19627588
references.citation: Soc Sci Med. 1993 Aug;37(3):369-83
references.pmid: 8356485
references.citation: Acta Paediatr. 2007 Aug;96(8):1135-8
references.pmid: 17608829
references.citation: East Afr Med J. 2004 Nov;81(11):555-61
references.pmid: 15868963
references.citation: Lancet. 2004 Jun 12;363(9425):1948-53
references.pmid: 15194254
references.citation: Arch Dis Child. 2008 Jun;93(6):540-4
references.pmid: 18495913
references.citation: J Midwifery Womens Health. 2005 Jul-Aug;50(4):329-34
references.pmid: 15973271
references.citation: BMC Public Health. 2008 Jun 03;8:194
references.pmid: 18522737
references.citation: Health Serv Res. 1998 Oct;33(4 Pt 2):1059-90
references.pmid: 9776949
references.citation: Int J Gynaecol Obstet. 2007 Sep;98(3):285-90
references.pmid: 17617415
references.citation: JAMA. 1988 Sep 23-30;260(12):1743-8
references.pmid: 3045356
references.citation: J Perinatol. 2005 Mar;25 Suppl 1:S82-91
references.pmid: 15791282
references.citation: East Afr Med J. 2004 Jun;81(6):293-9
references.pmid: 16167676
references.citation: Int J Qual Health Care. 2001 Dec;13(6):475-80
references.pmid: 11769750
references.citation: Bull World Health Organ. 2008 May;86(5):349-55
references.pmid: 18545737
references.citation: Health Policy Plan. 2008 Mar;23(2):101-17
references.pmid: 18267961
references.citation: Bull World Health Organ. 2008 Feb;86(2):132-9
references.pmid: 18297168
references.citation: Bull World Health Organ. 1995;73(1):105-14
references.pmid: 7704920
references.citation: Trans R Soc Trop Med Hyg. 2006 Oct;100(10):899-908
references.pmid: 16757009
references.citation: Arch Dis Child. 2008 Sep;93(9):799-804
references.pmid: 18719161
references.citation: Lancet. 2001 Jan 13;357(9250):106-10
references.pmid: 11197397