title: Quality of neonatal healthcare in Kilimanjaro region, northeast Tanzania: learning from mothers' experiences.
abstract: BACKGROUND
  With a decline of infant mortality rates, neonatal mortality rates are striking high in development countries particularly sub Saharan Africa. The toolkit for high quality neonatal services describes the principle of patient satisfaction, which we translate as mother's involvement in neonatal care and so better outcomes. The aim of the study was to assess mothers' experiences, perception and satisfaction of neonatal care in the hospitals of Kilimanjaro region of Tanzania.
  
  
  METHODS
  A cross sectional study using qualitative and quantitative approaches in 112 semi structured interviews from 14 health facilities. Open ended questions for detection of illness, care given to the baby and time spent by the health worker for care and treatment were studied. Probing of the responses was used to extract and describe findings by a mix of in-depth interview skills. Closed ended questions for the quantitative variables were used to quantify findings for statistical use. Narratives from open ended questions were coded by colours in excel sheet and themes were manually counted.
  
  
  RESULTS
  80 mothers were interviewed from 13 peripheral facilities and 32 mothers were interviewed at a zonal referral hospital of Kilimanjaro region. 59 mothers (73.8%) in the peripheral hospitals of the region noted neonatal problems and they assisted for attaining diagnosis after a showing a concern for a request for further investigations. 11 mothers (13.8%) were able to identify the baby's diagnosis directly without any assistance, followed by 7 mothers (8.7%) who were told by a relative, and 3 mothers (3.7%) who were told of the problem by the doctor that their babies needed medical attention. 24 times mothers in the peripheral hospitals reported bad language like "I don't have time to listen to you every day and every time." 77 mothers in the periphery (90.6%) were not satisfied with the amount of time spent by the doctors in seeing their babies.
  
  
  CONCLUSIONS
  Mothers of the neonates play great roles in identifying the illness of the newborn. Mother's awareness of what might be needed during neonatal support strategies to improve neonatal care in both health facilities and the communities.
authors: Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical Center, P,O Box 2236, KCMC, Moshi, Tanzania. benmbwele@gmail.com
authors: Bernard
authors: B
authors: Mbwele
authors: Nicole L
authors: NL
authors: Ide
authors: Elizabeth
authors: E
authors: Reddy
authors: Sarah A P
authors: SA
authors: Ward
authors: Joshua A
authors: JA
authors: Melnick
authors: Flavian A
authors: FA
authors: Masokoto
authors: Rachael
authors: R
authors: Manongi
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D006767:Hospitals, District / Q000592:standards; D006801:Humans; D007224:Infant Care / Q000592:standards*; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000175:diagnosis / Q000628:therapy*; D007407:Interviews as Topic; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011787:Quality of Health Care; D013636:Tanzania; D062606:Tertiary Care Centers / Q000592:standards; D055815:Young Adult
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