Newborn signal functions in Bangladesh: Identification through expert consultation and assessment of readiness among public health facilities

Shema Mhajabin; Goutom Banik; Muhammad Shariful Islam; Md Jahurul Islam; Tazeen Tahsina; Farid Uddin Ahmed; Mushair Ul Islam; Md Abdul Mannan; Sanjoy Kumer Dey; Samina Sharmin; Fida Mehran; Mahbuba Khan; Anisuddin Ahmed; Ahmed Al Sabir; Shahin Sultana; Ziaul Ahsan; Sayed Rubayet; Joby George; Afsana Karim; Muhammad Shahidullah; Shams El Arifeen; Ahmed Ehsanur Rahman

doi:10.7189/jogh.12.04079

Newborn signal functions in Bangladesh: Identification through expert consultation and assessment of readiness among public health facilities

J Glob Health. 2022 Sep 17:12:04079. doi: 10.7189/jogh.12.04079.

Authors

Shema Mhajabin^#¹, Goutom Banik^#¹, Muhammad Shariful Islam², Md Jahurul Islam², Tazeen Tahsina¹, Farid Uddin Ahmed³, Mushair Ul Islam², Md Abdul Mannan⁴, Sanjoy Kumer Dey⁴, Samina Sharmin⁵, Fida Mehran⁶, Mahbuba Khan⁷, Anisuddin Ahmed¹, Ahmed Al Sabir⁸, Shahin Sultana⁹, Ziaul Ahsan¹⁰, Sayed Rubayet¹⁰, Joby George¹¹, Afsana Karim¹¹, Muhammad Shahidullah¹², Shams El Arifeen¹, Ahmed Ehsanur Rahman¹

Affiliations

¹ Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
² Directorate General of Health Services, Government of Bangladesh Ministry of Health and Family Welfare, Bangladesh.
³ Directorate General of Family Planning, Ministry of Health & Family Welfare, Bangladesh.
⁴ Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
⁵ Unicef, Dhaka, Bangladesh.
⁶ USAID, Dhaka, Bangladesh.
⁷ World Health Organization, Dhaka, Bangladesh.
⁸ RTM International, Dhaka, Bangladesh.
⁹ National Institute of Population Research and Training, Dhaka, Bangladesh.
¹⁰ Ipas, Dhaka, Bangladesh.
¹¹ Save the Children, Dhaka, Bangladesh.
¹² National Technical Working Committee, Newborn Health, Bangladesh.

^# Contributed equally.

PMID: 39772287
DOI: 10.7189/jogh.12.04079

Abstract

Background: This study aimed to identify a set of newborn signal functions (NSFs) that can categorize health facilities and assist policymakers and health managers in appropriately planning and adequately monitoring the progress and performance of health facilities delivering newborn health care in Bangladesh and similar low-income settings.

Methods: A modified Delphi method was used to identify a set of NSFs and a cross-sectional health facility assessment among the randomly selected facilities was conducted to test them in public health facilities in Bangladesh. In the modified Delphi approach, three main steps of listing, prioritizing, and testing were followed to identify the set of NSFs. Then, to finalize the set of NSFs and its variables, a total of five Delphi workshops and three rounds of Delphi surveys were conducted. Finally, 205 public health facilities located in 41 randomly selected districts were assessed for the availability and readiness of finalized NSFs using the updated tool of Bangladesh Health Facility Survey (BHFS) 2017.

Results: Twenty NSFs were identified and finalized, nine of which were categorized as primary NSFs, 13 as basic NSFs, 18 as comprehensive NSFs, and 20 as advanced NSFs. Almost all district hospitals (DHs), Upazila health complexes (UHCs,) and maternal and child welfare centres (MCWCs) performed the primary NSFs in the last three months. However, around one-third of the union health and family welfare centres (UH&FWCs) and very few community clinics (CCs) performed them during the same period. The basic, comprehensive, and advanced NSF readiness was inadequate and inappropriate across all types of facilities, including DHs and UHCs.

Conclusions: In the absence of internationally or nationally agreed-upon NSFs to measure a health facility's service availability and readiness for providing newborn care, this study becomes the first to identify and finalize a set of NSFs and to incorporate relevant variables in the health facility assessment tool which can be used to monitor the availability and readiness of a newborn care facility. The identified NSFs can also be adapted for the countries with similar contexts and can serve as a standard base to determine a global set of NSFs.