Neonatal care practices in Buikwe District, Uganda: a qualitative study

BACKGROUND: Sub-Saharan Africa is the region with the highest neonatal mortality rate, with Uganda reporting 20 deaths per 1000 live births. The Uganda Clinical Guidelines (UCG) from 2016 have detailed descriptions on care for mothers and their newborns during pregnancy, delivery and the post-partum period. The objective of the study was to identify provider and user perspectives regarding the knowledge of and adherence to the UCG recommendations in aspects of delivery and newborn care, both in cases of normal as well as complicated births. METHODS: The study used qualitative methods with data collection from participant observations, interviews with key-informants and focus group discussions. Malterud's Systematic Text Condensation (STC) was used for analysis. RESULTS: The study found low knowledge about the UCG among the health workers. Various discrepancies between performed hands-on-procedures and the UCG were found related to neonatal care practices, including low use of partograms, uncertainty around timing for cord clamping, routine oronasopharyngeal suction of newborns and inadequate implementation of skin-to-skin care. CONCLUSIONS: Continued focus on systemic strategies for further implementation of the UCG is recommended.