Abstract:
Neonatal mortality currently accounts for 45% of all child mortality in Kenya, standing at
22 per 1000 live births. Access to basic but high quality inpatient neonatal services for
small and sick newborns will be key in reducing neonatal mortality. Neonatal inpatient
care is reliant on nursing care, yet explicit nursing standards for such care do not
currently exist in Kenya. We reviewed the Nursing Council of Kenya 'Manual of Clinical
Procedures' to identify tasks relevant for the care of inpatient neonates. An expert
advisory group comprising major stakeholders, policy-makers, trainers, and frontline
health-workers was invited to a workshop with the purpose of defining tasks for which
nurses are responsible and the minimum standard with which these tasks should be
delivered to inpatient neonates in Kenyan hospitals. Despite differences in opinions at the
beginning of the process, consensus was reached on the minimum standards of neonatal
nursing. The key outcome was a comprehensive list and grouping of neonatal nursing
task and the minimum frequency with which these tasks should be performed. Second, a
simple categorisation of neonatal patients based on care needs was agreed. In addition,
acceptable forms of task sharing with other cadres and the patient's family for the
neonatal nursing tasks were agreed and described. The process was found to be
acceptable to policy-makers and practitioners, who recognised the value of standards in
neonatal nursing to improve the quality of neonatal inpatient care. Such standards could
form the basis for audit and quality evaluation.