Immediate Newborn Care and Associated Outcomes in the Delivery Room: An Observational Study in Rwanda

Abstract

Background Neonatal mortality is a worldwide concern, especially in sub-Sahara Africa. Millions of newborn deaths could be prevented with quality care at birth. Objective To identify immediate newborn care provided by birth attendants and associated outcomes in the delivery room of a district hospital in Kabgayi, Rwanda. Methods This study used a descriptive cross-sectional design and convenience sampling strategy. The sample of 171 newborns and birth attendants were observed in the delivery room using a standardized checklist during April and May 2019. Descriptive statistics were used to analyze data. Results The majority (65.5%) of newborns were female, and at term (93.6%). The majority had mouth and nose cleared (60%), dried thoroughly (75.4%), wet cloth removed (57.3%), delayed umbilical cord clamping (67.3%), and immediate skin-to-skin contact (67.3%). Limited interventions included APGAR evaluation (28%) and breastfeeding within the first hour (36.6%). The majority of 135(78.9%) were stable, and none died. Conclusion The majority of the study population was stable, though all newborns did not benefit from standard immediate newborn care. To reduce neonatal mortality and morbidity in Rwanda, we need to redouble efforts to strengthen the quality of immediate newborn care. Future research is needed to identify effective training to improve newborn outcomes at birth.