Neonatal unit human resources: coverage for six cadres and trends for staff-to-baby ratios in 65 neonatal units implementing with NEST360 in Kenya, Malawi, Nigeria, and Tanzania

作者：Rebecca E. Penzias, Eric O. Ohuma, Opeyemi Odedere, Olabisi Dosunmu, George Okello, Hannah Mwaniki, Robert Tillya, Josephine Shabani, Samuel Ngwala, Evelyn Zimba, Morris Ogero, Christine Bohne, Olukemi Oluwatoyin Tongo, Chinyere Ezeaka, Vincent Ochieng, Ekran Rashid, William Macharia, John Wainaina, Irabi Kassim, Donat Shamba, Nahya Salim, Grace Tahuna Soko, Msandeni Chiume, Alice Tarus, Edith Gicheha, Thomas Julius, Georgia Jenkins, James Cross, Rosemary Kamuyu, Junwei Chen, Simon Cousens, Elizabeth Molyneux, Maria Odén, Rebecca Richards‐Kortum, Joy E Lawn, David Gathara, with the Data Collection Learning Collaborative Group, Mbozu Sipalo, Millicent Alooh, Steve Adudans, Dolphine Mochache, Christina Mchoma, Joseph Bilitinyu, Pius Chalamanda, Mirriam Dzinkambani, Ruth Mhango, Fanny Stevens, Joseph Mulungu, Blessings Makhumula, Loveness Banda, Charles Banda, Brian Chumbi, Chifundo Banda, Evelyn Chimombo, Nicodemus Nyasulu, Innocent Ndau, Pilirani Kumwembe, Edna Kerubo, Nyphry Ambuso, Kevin Koech, Noel Waithaka, Calet Wakhungu, Steven Otieno, Felix Bahati, Josphine Ayaga, Jedida Obure, Nellius Nderitu, Violet Mtambo, George Mkude, Mustapha Miraji, Caroline Shayo, Camilius Nambombi, Christopher Cyrilo, Temilade Aderounmu, Akingbehin Wakeel Wale, Odeleye Victoria Yemisi, Akinola Amudalat Dupe, Samuel Awolowo, Addie Oluwaseun, John Ajiwohwodoma Ovuoraye, Balogun Adeleke Mujaid, Adedoyin Fetuga, Juilana Okanlawon, Flora Awosika, Awotayo Olasupo Michael, Omotayo Adegboyega Abiodun · 发表于：Human Resources for Health · 年份：2025 · DOI：10.1186/s12960-025-01031-1 · 被引用次数：6 · 研究领域：Global Maternal and Child Health、Global Health Care Issues、Maternal and Neonatal Healthcare

BACKGROUND: Implementing small and sick newborn care (SSNC) requires skilled health workers; however, there is a shortage, adversely impacting patient outcomes and health worker well-being. There are limited data and no current World Health Organization (WHO) standards for staff-to-baby ratios in neonatal units in low- and middle-income countries (LMICs) to inform policy, planning, and investment. METHODS: In 65 neonatal units (36 in Malawi, 13 in Kenya, 7 in Tanzania, and 9 in Nigeria), a health facility assessment (HFA) for SSNC and government-led quality improvement (QI) processes were implemented. Staffing data were collated from baseline HFA (Sept 2019-March 2021) and mid-2023 HFAs, and quarterly QI processes. The unit of analysis was the neonatal unit with day and night staff-to-baby ratios calculated. Ratios were aggregated overall, by country, by hospital level, and by neonatal unit occupancy rates. Staff coverage and skill-mix were also analysed for nurses, doctors, clinical officers, laboratory technicians, data clerks, biomedical technicians, and engineers. RESULTS: For 65 neonatal units, the median time between baseline and 2023 HFAs was 31 months (Interquartile Range (IQR) 29-34 months). In 2023, only 3 (5%) neonatal units had zero neonatal ward-specific nurses compared to 8 (12%) at baseline during the day. Between baseline and 2023 HFAs, median nurse-to-baby ratios were 1:6 (IQR 1:3-1:11) during the day and 1:10 (IQR 1:6-1:17) at night, with consistency over ti...