PSBI Implementation Research

Neonatal infections remain a leading cause of newborn deaths globally. In 2015, WHO issued guidelines for managing possible serious bacterial infection (PSBI) in young infants (0-59 days) using simplified antibiotic regimens when compliance with hospital referral is not feasible. Bangladesh was one of the first countries to adopt WHO’s guidelines for implementation. We conducted an implementation research study that assessed facility readiness and provider performance in three rural sub-districts of Bangladesh during August 2015-August 2016. This study took place in 19 primary health centers. Facility readiness was assessed using checklists completed by study staff at three time points. To assess provider performance, we extracted data for all young infants (N=1052) from facility registers on a weekly basis and compared providers’ diagnosis and treatment against the guidelines for those infants classified with infection. Focus group discussions (FGDs) and in-depth interviews (IDIs) with providers were conducted to identify barriers and facilitators for facility readiness and provider performance. FGDs were conducted in the first 3 months of the study period. IDIs were conducted every three months, including follow-up interviews for member checking of themes in the final months of the study period.