BACKGROUND : Many neonatal deaths can be prevented globally through effective resuscitation.
South Africa (SA) committed towards attaining the Millennium Development Goal 4 (MDG4)
set by the World Health Organization (WHO). However, SA’s district hospitals have the
highest early neonatal mortality rates. Modifiable and avoidable causes associated with
patient-related, administrative and health care provider factors contribute to neonatal
mortality. A quality improvement initiative in neonatal resuscitation could contribute towards
decreasing neonatal mortality, thereby contributing towards the attainment of the MDG4.
AIM : The aim of this study was, (1) to explore and describe the existing situation regarding
neonatal resuscitation in a district hospital, (2) to develop strategies to sustain a neonatal
resuscitation quality improvement initiative and (3) to decrease neonatal mortality. Changes
that occurred and the sustainability of strategies were evaluated.
SETTING : A maternity section of a district hospital in South Africa.
METHODS : The National Health Service (NHS) Sustainability Model formed the theoretical
framework for the study. The Problem Resolving Action Research model was applied and the
study was conducted in three cycles. Purposive sampling was used for the quantitative and
qualitative aspects of data collection. Data was analysed accordingly.
RESULTS : The findings indicated that the strategies formulated and implemented to address
factors related to neonatal resuscitation (training, equipment and stock, staff shortages, staff
attitude, neonatal transport and protocols) had probable sustainability and contributed
towards a reduction in neonatal mortality in the setting.
CONCLUSION : These strategies had the probability of sustainability and could potentially
improve neonatal outcomes and reduce neonatal mortality to contribute toward South Africa’s’
drive to attain the MDG4.
C.v.H. was the main researcher as doctoral candidate at the
time of the study and main author of this study. C.M. was the
supervisor and E.v.R. was the co-supervisor for the study.