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3 results on '"Chetna Chaudhary"'

1. Improvements in essential newborn care and newborn resuscitation services following a capacity building and quality improvement program in three districts of Uttar Pradesh, India

Author

Manoja Kumar Das, Chetna Chaudhary, Sadhu Charan Mohapatra, Vinod Kumar Srivastava, Najam Khalique, Santosh Kumar Kaushal, Rajesh Khanna, and Surojit Chatterji

Subjects
Capacity building, newborn care, quality of care, resuscitation, Public aspects of medicine, RA1-1270
Abstract

Background: Neonatal death remains a global challenge contributing to 45% of underfive deaths. With rising institutional delivery, to accelerate decline in neonatal mortality rate (NMR) improvement in the quality of perinatal care requires attention. Objectives: This implementation research targeted improving service delivery readiness for quality of newborn care at public health facilities in three districts of Uttar Pradesh, India, with high NMR. Materials and Methods: This before-after study assessed the facility readiness and quality of newborn services at 42 health facilities. The changes in 26 signal functions for routine and emergency obstetric and newborn care were tracked. Results: There was marked improvement in newborn service availability: skilled birth attendants (51%), resuscitation (30%), and kangaroo mother care (27%) at these facilities. A multifold rise in newborn resuscitation efforts and documentation (n = 4431 vs. n = 144 in preintervention period) with high success rate (98.6%) was observed. There was also improvement in obstetric care services including partograph use (31%) and active management of third stage of labor (46%). However, several infrastructural indicators (electricity, water supply, toilets, and sanitation) remained unchanged. Conclusion: Overall improvements were observed in the majority of the signal functions for perinatal care and newborn resuscitation efforts. There was a limited impact on the infrastructural and supervision components.

Published
2018
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2. Impact of Neonatal Resuscitation Capacity Building of Birth Attendants on Stillbirth Rate at Public Health Facilities in Uttar Pradesh, India

Author

Manoja Kumar Das, Surojit Chatterji, Rajesh Khanna, Santosh Kumar Kaushal, and Chetna Chaudhary

Subjects
medicine.medical_specialty, Resuscitation, Capacity Building, Psychological intervention, India, Midwifery, 03 medical and health sciences, 0302 clinical medicine, Education, Nursing, Continuing, Pregnancy, 030225 pediatrics, Environmental health, Health care, Infant Mortality, medicine, Humans, 030212 general & internal medicine, business.industry, Public health, Infant, Newborn, Infant, Stillbirth, medicine.disease, Hospitals, District, Infant mortality, Outcome and Process Assessment, Health Care, Pediatrics, Perinatology and Child Health, Feasibility Studies, Education, Medical, Continuing, Female, Implementation research, business, Neonatal resuscitation
Abstract

Objective To document the impact of neonatal resuscitation capacity building of birth attendants at district and sub-district level on fresh stillbirth within the public health system in India. Design An implementation research using pre-post study design. Setting 3 high-infant and neonatal mortality districts (Gonda, Aligarh and Raebareli) of Uttar Pradesh, India. Participants Pregnant women who delivered at the health facilities and their newborns. Interventions An intervention package with (i) training on essential newborn care resuscitation; (ii) skill laboratories establishment for peer-interactive learning; (iii) better documentation; and (iv) supportive supervision was implemented at all health facilities in the districts. Main outcome measures Impact on fresh stillbirth rates and resuscitation practices were documented at 42 health facilities (Gonda-17, Aligarh-8 and Raebareli-17) over 12-18 months. Results Out of the 3.3% (4431/133627) newborns requiring resuscitation, 58.5% (n=2599) were completely revived, 19% (n=842) had some features of hypoxic insult after birth and 1.4% (n=62) were stillbirths. There was 15.6% reduction in still birth rate in the three districts with the intervention package. Conclusions The reduction in still birth rate and improvement in newborn resuscitation efforts in the three districts indicated feasibility of implementation and scalability of the intervention package. However sustenance of the impact over longer period needs documentation.

Published
2019

3. Retention of knowledge and skill of birth attendants in newborn care and resuscitation after 1 Year in clinical practice: An experience from India

Author

Arti Maria, Rajesh Khanna, Santosh Kumar Kaushal, Chetna Chaudhary, Ashish Jain, Surender Singh Bisht, Surojit Chatterji, and Manoja Kumar Das

Subjects
Resuscitation, medicine.medical_specialty, Neonatal mortality, business.industry, Public health, education, medicine.disease, Perinatal asphyxia, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Family medicine, Pediatrics, Perinatology and Child Health, medicine, 030212 general & internal medicine, Uttar pradesh, business, Newborn care, Neonatal resuscitation
Abstract

Background: In India, 18%–20% of newborn deaths are attributed to perinatal asphyxia. Effective resuscitation at birth can prevent neonatal mortality and improve the chances of intact survival. The information about sustainability and retention of gained resuscitation knowledge and skill in India is limited. Objective: The objective of this study is to evaluate the retention of newborn care and resuscitation knowledge and skill of birth attendants at public health facilities after 1 year of clinical practice at the health facilities within Public Health System in India. Methods: In three districts of Uttar Pradesh, knowledge and skill status of 168 birth attendants (54 doctors and 114 nurses) were documented at pre- and posttraining and after 1 year. Results: There was a marked improvement in knowledge scores (doctors: 42%–85% and nurses: 35%–86%) and skill scores (doctors: 15%–89% and nurses: 15%–90%) after training. There was significant retention of knowledge (doctors 58% and nurses 52%) and skill (doctors 82% and nurses 79%) after 1 year, although there was knowledge–skill gap observed after 1 year. Conclusion: The improvement and retention of skill and knowledge among the birth attendants were encouraging. The differential retention of skill and knowledge may be due to the training methodology and opportunity for skill refresher through the skill laboratories.

Published
2018

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