Adherence to Comprehensive Newborn Care Protocol by Healthcare Providers and Its Association with Growth Outcomes in Preterm Infants at Muranga County Referral

Abstract

Preterm birth, defined as delivery before 37 weeks of gestation, remains a major public health concern, particularly in low- and middle-income countries (LMICs) such as Kenya. Despite advancements in neonatal care, adherence to Comprehensive Newborn Care Protocols (CNCPs) remains inconsistent, affecting growth outcomes in preterm infants. This study assessed healthcare providers’ adherence to CNCPs at Muranga County Referral Hospital and its association with preterm infant growth outcomes. A cross-sectional descriptive design was employed, using structured questionnaires to collect data from healthcare providers on adherence to CNCPs. Quantitative analysis was conducted using descriptive and inferential statistics in SPSS. Results showed moderate adherence to CNCPs, with variations across key indicators: feeding fluids (Mean = 3.23, SD = 0.82), breastfeeding support (Mean = 3.24, SD = 1.09), and weight gain monitoring (Mean = 3.23, SD = 0.69). Determinants such as knowledge and competency (Mean = 3.2, SD = 0.89), beliefs and attitudes (Mean = 3.15, SD = 1.12), and years of experience (Mean = 3.16, SD = 0.65) significantly influenced adherence. Growth outcomes, measured by weight gain information, were positively correlated with adherence levels (Mean = 3.24, SD = 0.56), indicating that improved compliance with CNCPs enhances preterm infant growth. The study highlights gaps in adherence to CNCPs and underscores the need for targeted interventions, such as continuous training, attitude transformation programs, and improved resource allocation, to optimize neonatal care and improve preterm infant growth outcomes. These results provide valuable insights for policymakers and healthcare practitioners in LMICs focused on enhancing neonatal survival and development.