Table 1 Selected WHO domains for quality standards [13] and additional specific needs of mothers, newborns and families of stillborn infants
WHO domains | Additional specific needs of newborns |
|---|---|
Experience of care | |
Standard 4: Communication with women and their families is effective and responds to their needs and preferences. | • Only medically necessary separation of mother and newborn • All procedures and referrals are consented by the caregiver • Education on proper essential newborn care for all infants during clinic stay and at discharge • Supportive breastfeeding counselling and demonstrations • Translation and interpretation services made available • Timely follow up with bereaved families about causes of death when available |
Standard 5: Women and newborns receive care with respect and preservation of their dignity. | • Competent providers and staff, who are trained to use appropriate non-judgmental language • Newborns handled in gentle and safe ways • Newborns cared for by an adult at all times • Home-born infants receive the same quality of service as facility-born infants at postnatal care visits • Avoidance of unnecessary, painful procedures • Stillborn infants are given respect and choices given to the family about how to grieve or memorialise infant, including supported opportunities to engage in parenting according to their needs and preferences, such as naming, seeing, holding, and meeting the newborn |
Standard 6: Every woman and her family are provided with emotional support that is sensitive to their needs and strengthens the woman’s capability. | • Provision of warm, safe environments for newborns • Promotion of skin to skin care, immediate breastfeeding, and feeding on demand • Dry, warm clothing or wrapper for newborns as much as possible • Prompt removal of soiled wrapper or diaper and cleaning of urine and faeces • Services provided for women and newborns with disabilities • Services provided for HIV-exposed infants and efforts made to reduce stigma • Acceptance of various family types and parental role arrangements • Encouragement of familial or community postnatal care support • Facilitation of postpartum “mother’s groups” or other support structures |
Quality of care | |
Standard 7: For every woman and newborn, competent, motivated staff are consistently available to provide routine care and manage complications. | • Staff confident in providing essential newborn care • Staff trained to handle critically-ill newborns • Staff trained in compassionate care for bereaved families, and counselling services available |
Standard 8: The health facility has an appropriate physical environment, with adequate water, sanitation and energy supplies, medicines, supplies and equipment for routine maternal and newborn care and management of complications. | • Areas for delivery and newborn care kept clean and warm • Specific equipment clean and ready for low birth weight or preterm infants and other potentially critical newborns • Separate postpartum area for parents of stillborn infants available |