Barriers and enablers of quality high-acuity neonatal care in sub-Saharan Africa: protocol for a synthesis of qualitative evidence.

INTRODUCTION: Neonatal intensive care unit (NICU) in sub-Saharan Africa face limited resources and systemic challenges, resulting in poorer quality care, higher infant mortality, and dissatisfaction among both patients and healthcare workers. This review aims to bridge the knowledge gap by identifying and analysing the key barriers and enablers affecting quality care, informing interventions to improve patient outcomes and overall NICU effectiveness in this critical region. METHODS AND ANALYSIS: This systematic review will search and gather data from a variety of databases, including JBI Database, Cochrane Database, MEDLINE/PubMed, CINAHL/EBSCO, EMBASE, PEDro, POPLINE, Proquest, OpenGrey (SIGLE), Google Scholar, Google, APA PsycINFO, Web of Science, Scopus and HINARI. The review will also include unpublished studies and grey literature from a variety of sources. This review will only include qualitative and mixed-methods studies that explore the barriers and enablers of quality care for high-acuity neonates using qualitative data collection and analysis methods. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research will be used by two independent reviewers to critically appraise the eligible studies. Any disagreements that arise will be resolved through discussion. Qualitative research findings will be pooled using the meta-aggregation approach in QARI software, where possible. Only unequivocal and credible findings will be included in the synthesis. If textual pooling is not possible, the findings will be presented in narrative form. ETHICS AND DISSEMINATION: This systematic review does not require ethical clearance, and the findings will be disseminated to relevant stakeholders to ensure the widest possible outreach and impact. PROSPERO REGISTRATION NUMBER: CRD42023473134.

Active Management of Third Stage of Labor: Practice and Associated Factors among Obstetric Care Providers in North Wollo, Amhara Region, Ethiopia.

BACKGROUND: World Health Organization strongly recommends that every obstetrical provider at birth needs to have knowledge and skills on active management of the third stage of labor and use it routinely for all women. However, implementation of this lifesaver intervention by skilled birth attendants is questionable because 3% to 16.5% of women still experience postpartum hemorrhage. Even though coverage of giving births at health facilities in Ethiopia increases, postpartum hemorrhage accounts for 12.2% of all maternal deaths occurring in the country. Lack of the necessary skills of birth attendants is a major contributor to these adverse birth outcomes. OBJECTIVES: This study aimed to assess the active management of the third stage of labor practice and associated factors among obstetric care providers. METHODS: An institution-based cross-sectional study design was applied from March 15 to April 15, 2020. Multistage sampling techniques were used to get 254 participants, and data were collected using self-administered structured questionnaires and an observation checklist. Data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Sciences (SPSS) version 23.0 for analyses. The multivariable logistic regression model was used at 95% confidence interval with P value <0.05. Among the 232 providers participating in the study, only 75 (32.3%) of respondents had a good practice. The practice of the provider was significantly associated with work experience (adjusted odd ratio 0.206 (95% confidence interval, 0.06-0.63)), knowledge (adjusted odd ratio (2.98 (95% confidence interval, 1.45-6.14)), the presence of assistance (adjusted odd ratio 2.04 (95% confidence interval, 1.06-3.93)), and time of uterotonic drug preparation (adjusted odd ratio 4.69 (95% confidence interval, 2.31-9.53)). CONCLUSION: Only one-third of obstetric care providers had good practice during active management of third stage of labor. Practice was significantly associated with work experience, knowledge, the presence of assistance during third-stage management, and time of uterotonic drug preparation. Consistent and sustainable on job training and clinical audit should be applied in all facilities with regular supportive supervision and monitoring. Furthermore, team work and adequate preparation should be done to facilitate the management of active third stage of labor.

Predictors of therapeutic communication between nurses and hospitalized patients.

BACKGROUND: Therapeutic communication is a purposeful interaction between health professionals and patients that helps to achieve positive health outcomes. There is a pressing need for research examining factors influencing effective implementation of therapeutic communication in relation to patient-centered care and satisfaction. OBJECTIVE: This study was aimed at determining the effective implementation of therapeutic communication and its predictors. METHODS: Institution based cross-sectional study was conducted at the Jimma University Specialized Hospital from March 21 to April 9, 2016. One hundred ninety two patients were recruited using stratified sampling. A questionnaire was used to collect data. One-way ANOVA for mean difference by socio-demographic characteristics, simple and multivariable linear regressions were conducted. RESULTS: The study revealed that 67(34.9%) of the patients rated high level of therapeutic communication. Significant predictors of therapeutic communication implementation were educational status (ß = 5.87, P = 0.011), language difference (ß = -6, P = 0.014), education difference (ß = 5.21, P = 0.010) and perceived patient view score (ß = 3.57, P˂0.001). CONCLUSION: Therapeutic communication was poorly implemented. Education, language difference, education difference and perceived patient view scores were significant predictors of therapeutic communication.

Relationship between leadership styles of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital.

BACKGROUND: Leadership style of nurse managers plays a significant role in nurses' job satisfaction. However, there is limited literature in areas related to nurses' manager leadership style. The objective of this research was thus to investigate the relationship between leadership style of nurse managers and nurses' job satisfaction in Jimma University Specialized Hospital. METHODS: The study was conducted at Jimma University Specialized Hospital from January to June 2012 and used a non-experimental correlation design. All full time, non-supervisory nurses with an experience of more than one year in nursing profession were participated in the study. The Multifactor Leadership Questionnaire and Minnesota Satisfaction Questionnaire were used to collect data. Data were entered and analyzed using SPSS version16.0 statistical software. The results were analyzed through descriptive statistics followed by the application of inferential statistics on the variables. Significance level was considered when p<0.05. RESULTS: A total of 175 copies of the questionnaires were returned out of 186 copies distributed to respondents. The result indicated that nurses can prefer transformational leadership style over transactional leadership style and had moderate-level intrinsic (M=2.72, SD=0.71) but low level of extrinsic job satisfaction (M=1.83, SD=0.68). Furthermore, from transactional leadership, only contingent reward was found to be statically significant and correlated with extrinsic (B=0.45, p<0.01) and intrinsic job satisfaction (B=0.32, p<0.05) while all five dimension of transformational leadership style were statistically significant and correlated with both intrinsic and extrinsic job satisfaction. CONCLUSION: Nurses tended to be more satisfied with the transformational leadership than transactional leadership style. Therefore, nurses' managers should use transformational leadership style in order to increase nurses' job satisfaction.