Conference abstract

Health facilities readiness to manage preterm labour using antenatal corticosteroids in Jinja Regional Referral Hospital catchment area, Uganda, 2016

Pan African Medical Journal - Conference Proceedings. 2017:3(39).17 Dec 2017.
doi: 10.11604/pamj-cp.2017.3.39.147

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Keywords: Antenatal corticosteroids, neonatal mortality, preterm
Oral presentation

Health facilities readiness to manage preterm labour using antenatal corticosteroids in Jinja Regional Referral Hospital catchment area, Uganda, 2016

Christine Begumisa1,&, Peter Waiswa1, Aloysius Ssennyonjo1, Michael Ediau1, Doreen Tuhebwe1

1Makerere University School of Public Health, Kampala, Uganda

&Corresponding author
Christine Begumisa, Makerere University School of Public Health, Kampala, Uganda

Abstract

Introduction: antenatal corticosteroids (ACS) reduce neonatal mortality among preterm babies. However, when used inappropriately, they can increase neonatal mortality and the risk of maternal infections. As a consequence, WHO published guidelines for the use of ACS when managing preterm labour. This study therefore, assessed the readiness of health facilities to manage preterm labour using ACS as per the new WHO guidelines.

Methods: a hospital based cross-sectional study was conducted in 6 hospitals and 8 Health center IVs between February and July 2016. Data on ACS use was collected from 354 medical records (November 2015 to March 2016) of mothers who delivered preterm babies after 24 and before 37 completed weeks of gestation using a predesigned data extraction tool. A readiness assessment tool and pretested semi-structured questionnaire were used to collect data on readiness. Non-parametric methods were used to test the facilitiesí Readiness to use ACS.

Results: the overall facility readiness index (mean availability of items required for ACS use) was 82% lower than the reference (90%). The difference in the mean of overall readiness index of hospitals (90.3%) and HCIVs (75.8%) was statistically significant (p-value = 0.028). Prevalence of ACS use was low (13.6%, 48/354), mainly due to unavailability of ACS. Appropriate ACS use was 68.8% (33/48) and inappropriate use was 31.3% (15/48), due to absence of the new guidelines as well as low knowledge levels. Health workers in HCIVs had lower knowledge about when and how to administrator the correct dose of ACS compared to those from hospitals.

Conclusion: there was low health facility readiness for ACS use. Health workers lacked adequate knowledge about appropriate ACS use. This inappropriate use may increase neonatal and risk of maternal mortality. Therefore, Ministry of Health and partners should adopt the new WHO guidelines of ACS use at all facility levels.