Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks
Abstract Background Neonatal mortality accounts for more than 47% of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitabl...
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doaj-f09b184af7f24747a4ef23cb773a198a2021-05-23T11:18:55ZengBMCBMC Pregnancy and Childbirth1471-23932021-05-0121111010.1186/s12884-021-03800-xProgress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecksFariba Mirbaha-Hashemi0Batool Tayefi1Zahra Rampisheh2Arash Tehrani-Banihashemi3Mozhdeh Ramezani4Narjes Khalili5Omid Pournik6Rahim Taghizadeh-Asl7Abbas Habibelahi8Mohammad Heidarzadeh9Maziar Moradi-Lakeh10Preventive Medicine and Public Health Research Center, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesPreventive Medicine and Public Health Research Center, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesStatistics and Information Technology Management, School of Medicine, Iran University of Medical SciencesWorld Health Organization, WHO Representative’s officeNeonatal Health Office, Ministry of Health and Medical EducationNeonatal Health Office, Ministry of Health and Medical EducationPreventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Department of Community and Family Medicine, School of Medicine, Iran University of Medical SciencesAbstract Background Neonatal mortality accounts for more than 47% of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitable and high-quality care for mothers and newborns. We applied the bottleneck analysis tool offered by ENAP to identify obstacles and bottlenecks hindering the scale-up of newborn care across seven health system building blocks. Methods We applied the every newborn bottleneck analysis tool to identify obstacles hindering the scale-up of newborn care across seven health system building blocks. We used qualitative methods to collect data from five medical universities and their corresponding hospitals in three provinces. We also interviewed other national experts, key informants, and stakeholders in neonatal care. In addition, we reviewed and qualitatively analyzed the performance report of neonatal care and services from 16 medical universities around the country. Results We identified many challenges and bottlenecks in the scale-up of newborn care in Iran. The major obstacles included but were not limited to the lack of a single leading and governing entity for newborn care, insufficient financial resources for neonatal care services, insufficient number of skilled health professionals, and inadequate patient transfer. Conclusions To address identified bottlenecks in neonatal health care in Iran, some of our recommendations were as follows: establishing a single national authorizing and leading entity, allocating specific budget to newborn care, matching high-quality neonatal health care providers to the needs of all urban and rural areas, maintaining clear policies on the distribution of NICUs to minimize the need for patient transfer, and using the available and reliable private sector NICU ambulances for safe patient transfer.https://doi.org/10.1186/s12884-021-03800-xCommunity healthHealth equityHealth services developmentHealth systemsNeonatal healthQualitative research |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Fariba Mirbaha-Hashemi Batool Tayefi Zahra Rampisheh Arash Tehrani-Banihashemi Mozhdeh Ramezani Narjes Khalili Omid Pournik Rahim Taghizadeh-Asl Abbas Habibelahi Mohammad Heidarzadeh Maziar Moradi-Lakeh |
spellingShingle |
Fariba Mirbaha-Hashemi Batool Tayefi Zahra Rampisheh Arash Tehrani-Banihashemi Mozhdeh Ramezani Narjes Khalili Omid Pournik Rahim Taghizadeh-Asl Abbas Habibelahi Mohammad Heidarzadeh Maziar Moradi-Lakeh Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks BMC Pregnancy and Childbirth Community health Health equity Health services development Health systems Neonatal health Qualitative research |
author_facet |
Fariba Mirbaha-Hashemi Batool Tayefi Zahra Rampisheh Arash Tehrani-Banihashemi Mozhdeh Ramezani Narjes Khalili Omid Pournik Rahim Taghizadeh-Asl Abbas Habibelahi Mohammad Heidarzadeh Maziar Moradi-Lakeh |
author_sort |
Fariba Mirbaha-Hashemi |
title |
Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks |
title_short |
Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks |
title_full |
Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks |
title_fullStr |
Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks |
title_full_unstemmed |
Progress towards Every Newborn Action Plan (ENAP) implementation in Iran: obstacles and bottlenecks |
title_sort |
progress towards every newborn action plan (enap) implementation in iran: obstacles and bottlenecks |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-05-01 |
description |
Abstract Background Neonatal mortality accounts for more than 47% of deaths among children under five globally but proper care at and around the time of birth could prevent about two-thirds of these deaths. The Every Newborn Action Plan (ENAP) offers a plan and vision to improve and achieve equitable and high-quality care for mothers and newborns. We applied the bottleneck analysis tool offered by ENAP to identify obstacles and bottlenecks hindering the scale-up of newborn care across seven health system building blocks. Methods We applied the every newborn bottleneck analysis tool to identify obstacles hindering the scale-up of newborn care across seven health system building blocks. We used qualitative methods to collect data from five medical universities and their corresponding hospitals in three provinces. We also interviewed other national experts, key informants, and stakeholders in neonatal care. In addition, we reviewed and qualitatively analyzed the performance report of neonatal care and services from 16 medical universities around the country. Results We identified many challenges and bottlenecks in the scale-up of newborn care in Iran. The major obstacles included but were not limited to the lack of a single leading and governing entity for newborn care, insufficient financial resources for neonatal care services, insufficient number of skilled health professionals, and inadequate patient transfer. Conclusions To address identified bottlenecks in neonatal health care in Iran, some of our recommendations were as follows: establishing a single national authorizing and leading entity, allocating specific budget to newborn care, matching high-quality neonatal health care providers to the needs of all urban and rural areas, maintaining clear policies on the distribution of NICUs to minimize the need for patient transfer, and using the available and reliable private sector NICU ambulances for safe patient transfer. |
topic |
Community health Health equity Health services development Health systems Neonatal health Qualitative research |
url |
https://doi.org/10.1186/s12884-021-03800-x |
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