ABSTRACT
BACKGROUND@#The practice of Unang Yakap or Essential Intrapartum and Newborn Care (EINC) during the COVID-19 pandemic poses a safety concern with regards to a newborn’s exposure to their COVID-19 suspected mother. @*OBJECTIVES@#This study aims to describe the experiences of COVID-19-suspected mothers and explore the factors influencing their decision to allow healthcare professionals to practice full EINC. Specifically, it aims to: 1) describe the experiences of mothers prior to, during, and immediately after delivery, and during postpartum care leading to their decision; and 2) explore the factors that influence the participant’s decision to practice EINC amidst the pandemic.@*METHODOLOGY@#For this phenomenological case study, online interviews with nine (9) participants were conducted using a 13-item questionnaire describing their experience. Thematic analysis using the inductive and semantic approach was conducted to identify the common themes or factors. @*RESULTS@#Of the nine (9) participants, five (5) experienced EINC, while four (4) did not. The COVID-19 status and the choice to undergo Unang Yakap were not a causal relationship. Two main influences, mother-related factors, and hospital-related factors, were identified and were found to have weight in decision-making. The mother-related factors include prior knowledge and perception towards EINC, COVID-19 status, personal beliefs, and information from social media; while the hospital-related factors are hospital facilities, hospital protocols, and HCW-patient relationship. @*CONCLUSION@#By delineating the different factors that influence mothers’ decisions, this study allows for the identification of possible bottlenecks in the practice of EINC, as well as effective and efficient means to encourage its practice.
Subject(s)
COVID-19ABSTRACT
BACKGROUND: The fourth Millennium Development Goal set out by the United Nations in 2000 aims to reduce under five-mortality globally, of which major contributor is neonatal mortality. Aside from the direct causes of neonatal deaths, newborns may die due to lack of access to the basic care. The World Health Organization started Essential Intrapartum and Newborn Care (EINC), an evidenced-based program that adapts safe and quality care for newborns and mothers. In response to this call, The Philippine Department of Health under Administrative Order 2009-0025, instituted Unang Yakap, a protocol compromised of four time-bound interventions. These are immediate drying, uninterrupted skin-to-skin contact, delayed cord clamping and early initiation of breastfeeding. This should be performed immediately and sequentially upon birth up to the 1st hour of life.OBJECTIVE: It is the aim of the study to assess the adherence of the obstetricians to performing these time-sensitive interventions during deliveries and to uncover substandard practices.METHODS: This prospective, cross-sectional, single-center study was conducted for 1 year. The birthing process was observed from pushing up to the 1st hour after birth. The timing and sequence of each newborn care intervention was recorded in a standardized assessment tool as they were performed. Other inventions not specified in the tool were also recorded.RESULTS: The steps of EINC were performed in 100% of deliveries. However, total adherence to the 4 time-bound interventions was less than 50%.CONCLUSION: This direct observational study shows that obstetricians were compliant to EINC in all the deliveries but adherent to the protocol in less than half only. Unnecessary interventions were observed although substandard practices were not demonstrated. The compliance of all birthing events to the protocol implies that EINC is a simple and uncomplicated procedure. Full adherence can be accomplished if physicians are re-oriented to the benefits of EINC.