Dissertation (MSc Pediatric Nursing)
The neonatal period is the most vulnerable time for a child’s survival because of the highest mortality and morbidity. Quarters of the global neonatal mortality is attributed to birth asphyxia due to failure of neonatal resuscitation; the highest burden of which is disproportionately concentrated in low and middle-income countries including Tanzania. Inadequate skills on neonatal resuscitation due to incompetent health care providers contributed significantly to this asphyxia-related mortality and morbidity. The study aimed at assessing the factors associated with knowledge, attitude and skills on neonatal resuscitation among nurse midwives in the Dodoma region, Tanzania. Hospital-based cross-sectional study design was employed among 340nurse/midwives selected by multistage sampling technique. A self-administered questionnaire and Observation checklist were used to collect data. Data were coded and entered into SPSS version 20 for analysis. Bivariate and multivariate logistic regression was used to assess factors associated with nurse/midwives' skills in neonatal resuscitation. Among 340 respondents (n=321, 94%) had adequate knowledge on neonatal resuscitation (n=290, 85%) had positive attitude on neonatal resuscitation while only (n=141, 41%) had adequate skills on neonatal resuscitation. After adjusted for confounders, factors associated with nurse/midwives knowledge was only the level of professional training, those with bachelor degree were 5 times to be knowledgeable (AOR=5.51, p<0.03) compared with those with certificate level of profession training. Factors associated with nurse/midwives’ positive attitudes were level of health facility [health centre (AOR=0.222, p<0.006), and Hospital (AOR=0.324, p<0.035)] compared to those working in dispensaries. Factors associated with adequate skills were; age of the midwives [20-34(AOR=O.082, p<0.008) and 35-49, (AOR=0.087, p<0.010)]; Being married (AOR=0.459, p=0.031); Working experience [worked 4-6] (AOR=2.905, p<0.003)and 10> years and above (AOR=12.825, p<0.000)]; working in District hospitals (AOR=1.544,p=0.032); Distance from place of residence [6-10km (AOR=0.090, p<0.001) and > 16km(AOR=0.049, p<0.001)]; Number of midwives per shift, ≥4(AOR=2.396, p=0.012) and Number of deliveries per day [6-10 (AOR=1.385, p<0.031), 11-20 (AOR=2.693, p<0.016)and >20 delivery per day (AOR=6.007, p<0.001) and knowledge on neonatal resuscitation [adequate knowledge were 3 times more likely to have adequate skills (AOR=3.87, p<0.041) compared to nurses with inadequate knowledge. The study had revealed that the majority of nurse midwives had adequate knowledge, positive attitude, and less than half of interviewed midwives had adequate skills on neonatal resuscitation. Moreover the study had shown that Nurse Midwives, who were young, married, with less than four years of working experience, working in dispensaries, living more than five kilometres from the working facility, fewer than four midwives per shift, and assist six deliveries per day were less likely to have good skills on neonatal resuscitation. The study recommends a deliberate effort to come up with a cost-effective strategy to empower these midwives on neonatal resuscitation in all aspects of knowledge, attitude and skills.