Published in PLOS One on 2026-06-11, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Solomon Mohammed Salia, Billie de Haas, Jelle Stekelenburg, Robert Kaba Alhassan
Source: PLOS One • DOI 10.1371/journal.pone.0350931
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The neonatal mortality rate in Ghana remains above the global average, which is far from meeting SDG 3.2. Notably, institutional neonatal deaths are on the increase, potentially due to healthcare professionals’ poor adherence to quality newborn care guidelines. This study assessed the adherence of clinical healthcare professionals to guidelines on quality newborn care in Ghana.
This observational study collected data from 158 healthcare professionals across six health facilities in Ghana. A data collection tool was developed based on the WHO standard for improving quality of care for small and sick newborns and the Ghana Health Services Standards for Newborn Health Services. The Mann-Whitney U test was used to measure differences in categorical data, while logistic regression models were employed to analyse the association between dependent and independent variables at a 95% confidence level. Six facility-level discussions with the observed healthcare professionals were held to validate and interpret the quantitative findings.
Overall, only 31 (20%) of healthcare professionals demonstrated good adherence to infection prevention and control (IPC), while 73 (46%) adhered poorly. Moderate adherence levels were seen in essential care for every newborn (ECEN) at 53% and respectful maternal and newborn care at 51%. During validation discussions, healthcare professionals mentioned poorly located handwashing materials, parental preference for methylated spirit over chlorhexidine for umbilical cord care, and lack of protocols for pain assessment as key barriers to adherence.
The study findings revealed low adherence levels to quality newborn care practices, especially in IPC practices. Moderate adherence levels were found in ECEN and respectful maternal and newborn care. These findings highlight the need to improve adherence with quality newborn care standards in Ghana. The Institutional Care and Family Health Divisions of the Ghana Health Service should integrate these findings into ongoing quality improvement efforts to achieve better neonatal outcomes.
Introduction
In 2022, approximately 2.3 million newborns died worldwide, with 75% of these deaths occurring within the first week of life [1]. Despite substantial efforts to reduce neonatal mortality (NM), it remains alarmingly high, especially in sub-Saharan Africa (SSA), where the neonatal mortality rate (NMR) is currently 27 deaths per 1,000 live births compared to the global rate of 17 deaths per 1,000 live births [2]. Newborns in SSA are 11 times more likely to die than those in many developed countries, such as Australia and New Zealand [2]. Ghana, like many SSA nations, continues to struggle with high neonatal mortality. The country’s NMR currently stands at 17 deaths per 1,000 live births [3]. The leading causes of neonatal death in Ghana include complications of prematurity, birth complications (birth injuries/asphyxia), newborn infections, low birth weight, neonatal jaundice, and congenital malformations [4–6]. Most of these causes are preventable.
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider hospital systems desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Solomon Mohammed Salia, Billie de Haas, Jelle Stekelenburg, Robert Kaba Alhassan. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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