Introduction The neonatal mortality rate (NMR) in Cambodia is 18 per 1000 births. The NMR in rural areas is higher, with a reported rate of 25 per 1000 in the province being studied. A large scale programme ‘The Saving Babies Lives Programme’ is currently being piloted to decrease neonatal deaths in Cambodia. To achieve this, an assessment of the current situation was necessary to highlight areas for improvement. Our aim was to create an assessment tool to obtain a comprehensive overview of neonatal services to inform the implementation of a sustainable improvement strategy.
Methods An assessment tool was adapted from the KAP survey model (Knowledge, Attitudes and Practice), comprising of both paper-based and tablet-based questionnaires. Two further sections were added; Equipment and Staffing, forming a ‘KAPES survey’. Tablet-based questionnaires were created using KoboCollect Toolbox. Topics chosen were developed with reference to national guidelines. Surveys were written in English and translated into Khmer.
Results Knowledge and attitude questions were developed across key areas depending on staff member (midwife, nurse or doctor). Knowledge questions were in the form of multiple-choice questions (MCQ). Attitude questions comprised of statements answered via a Likert scale. Practice, Equipment and Staffing (PES) questions were further categorised and question type included yes/no answers, MCQ, 5-point rating scales or free text. The PES surveys were adapted specific to location (health centre or hospital). Surveys were undertaken across 46 facilities in the province and later adapted to be more user-friendly and remove unnecessary questions.
Conclusions An assessment tool called a ‘KAPES survey’ was created to comprehensively assess neonatal services in rural Cambodia. Initial data collected will guide implementation of a strategy to decrease the NMR. Repeating the survey will evaluate progress of the intervention. Ultimately, this tool could assess services across the entire country and may be useful in other middle to low-income countries.
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