Newborn Care Practices in Health Facilities of Nepal: A Further Analysis from Nepal Health Facility Survey 2015 and 2021

IntroductionIncreased availability of Newborn care practices in health facilities (HFs) plays an important role in improving the survival and well-being of newborns. In this paper, we aimed to determine newborn care practices among HFs between 2015 and 2021, and associated factors among public and private HFs in Nepal. MethodsWe performed a secondary analysis of Nepal Health Facility Surveys 2015 and 2021. We summarized categorical variables with a weighted percent and 95% confidence interval (CI). We compared proportions using the z-test of proportion and reported differences in percentage points, 95% CI, and p-value. We applied univariate and multivariable logistic regression analysis to determine the association of the availability of seven newborn care practices. ResultsThe percentage of facilities with all seven newborn care practices was 50.5% (95% CI: 44.6, 56.3) in 2015 and 83.7% (95%CI: 79.8, 87.0) in 2021 with an overall increase of 34.2 percent points (95% CI: 27.9, 38.7). The availability of all seven newborn care practices significantly increased from 2015 to 2021 in each subcategory of the ecological region, all provinces except Madhesh, and all types of HFs except federal/provincial hospitals. In 2021, private hospitals had lower odds of having all seven newborn care practices compared to federal/provincial hospitals (AOR= 0.17, 95% CI: 0.07, 0.04). Similarly, in 2021, Sudurpaschim province had 2.87 (95% CI: 1.06, 8.31) higher odds of having all seven newborn care practices compared to Koshi province. In 2021, newborn care practices did not differ significantly based on ecological belt, quality assurance activities, external supervision, delivery service-related training and frequency of HF meeting. ConclusionThere was a significant increase in the availability of seven newborn care practices between 2015 and 2021 and in each category of ecological region, province, and type of facility. The type of facility and provinces were associated with the availability of newborn care practices among HFs in Nepal.