Introduction: Progress has been made in Kenya
towards reducing child mortality as part of efforts
aligned with the fourth Millennium Development Goal.
However, little advancement has been made in
reducing mortality among newborns, which now
accounts for 45% of all child deaths. The frequently
unanticipated nature of neonatal illness, its severity and
the high dependency of sick newborns on skilled care
make the provision of inpatient hospital services one
key component of strategies to improve newborn
survival.
Methods and analyses: This project aims to assess
the availability and quality of inpatient newborn care in
hospitals in Nairobi City County across the public,
private and not-for-profit sectors and align this to the
estimated need for such services, providing a
description of the quantity and quality gaps between
capacity and demand. The population level burden of
disease will be estimated using morbidity incidence
estimates from a literature review applied to subcounty
estimates of population-adjusted births, providing a
spatially disaggregated estimate of need within the
county. This will be followed by a survey of neonatal
services across all health facilities providing 24/7
inpatient newborn care in the county. The survey will
include: a retrospective audit of admission registers to
estimate the usage of facilities and case-mix of
patients; a structural assessment of facilities to gain
insight into capacity; a questionnaire to nursing staff
focusing on the process of delivering key obstetric and
neonatal interventions; and a retrospective case audit
to assess adherence to guidelines by clinicians.
Ethics and dissemination: This study has been
approved by the Kenya Medical Research Institute
Scientific and Ethics Review Unit (SSC protocol
No.2999). Results will be disseminated: to participating
facilities through individualised reports and a joint
workshop; to local and national stakeholders through
meetings and a summary report; and to the
international community through peer-review
publication and international meetings.