# Newborn examination practices and congenital anomaly detection in public health facilities in Addis Ababa, Ethiopia: a qualitative exploratory study

## TL;DR

This study explores newborn examination practices in Ethiopian hospitals to improve detection of birth defects.

## Contribution

The study identifies gaps in neonatal examination practices and proposes standardized protocols for congenital anomaly detection in Ethiopia.

## Key findings

- Examination practices are fragmented with inconsistent use of structured checklists and poor documentation.
- Training gaps among clinicians and non-physician staff hinder effective anomaly detection.
- A national checklist and comprehensive training programs are recommended to improve early detection.

## Abstract

Congenital anomalies are a leading cause of infant morbidity and mortality, particularly in low-resource settings. Early detection through standardized newborn examinations is critical but remains underexplored in Ethiopia.

This qualitative study systematically assesses neonatal examination practices in major public hospitals in Addis Ababa, Ethiopia, identifying gaps and proposing recommendations for standardized protocols.

We conducted twelve key informant interviews from November 2024 to January 2025 with pediatricians, obstetrician-gynecologists, and midwives from four large public hospitals using purposive sampling based on role and neonatal care experience. Interviews were transcribed verbatim and analyzed thematically following Braun & Clarke's framework. Coding was performed by two researchers; discrepancies were resolved by consensus. Trustworthiness was enhanced through member checking, peer debriefing, triangulation, and an audit trail.

Examination practices are fragmented, with inconsistent use of structured checklists and inadequate documentation. Training gaps among clinicians and non-physician staff were evident. There is strong interest in adopting checklist-based approaches to improve anomaly detection.

The findings highlight critical gaps in neonatal examination and documentation practices across the study sites. Developing a national checklist, comprehensive training programs, and mandatory protocols could strengthen early detection and management of congenital anomalies.