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.
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.
World Health Organization, Ghana Country Office, Accra, Ghana.
Mary N A
MN
Brantuo
Elizabeth
E
Cristofalo
Mira M
MM
Meheš
Juliana
J
Ameh
Nana Okai
NO
Brako
Frederick
F
Boahene
Stella B
SB
Adjei
Ernest
E
Opoku
Harriet
H
Banda
Yu T
YT
Wang
Abdulai A
AA
Forgor
Damien
D
Punguire
Kennedy
K
Brightson
Cynthia
C
Sottie
Seth
S
Owusu-Agyei
John E
JE
Williams
Abubakari
A
Sulemana
Abraham R
AR
Oduro
Margaret
M
Gyampong
Doris
D
Sarpong
Edith
E
Andrews
Martha
M
Gyansa-Lutterodt
Abraham
A
Hodgson
Cynthia
C
Bannerman
Fizan
F
Abdullah
D002423:Cause of Death; D055317:Evidence-Based Practice / Q000193:education* / Q000592:standards; D005869:Ghana / Q000453:epidemiology; D006767:Hospitals, District / Q000458:organization & administration; D006801:Humans; D007224:Infant Care / Q000379:methods / Q000592:standards*; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality / Q000517:prevention & control* / Q000628:therapy; D007318:Inservice Training / Q000379:methods; D007391:International Cooperation; D008396:Maryland; D008611:Mentors; D010043:Outcome and Process Assessment, Health Care; D010564:Personnel, Hospital / Q000193:education*; D011159:Population Surveillance / Q000379:methods; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards*; D014495:Universities; D000078329:Workforce; D014944:World Health Organization
Ghana; district hospitals; evidence-based; mentorship; neonatal mortality; training