Abstract
ObjectivesNeonatal mortality remains persistently high in low-income and middle-income countries. In Cambodia, there is a paucity of data on the perception of neonatal health and care-seeking behaviours at the community level. This study aimed to identify influencers of neonatal health and healthcare-seeking behaviour in a rural Cambodian province.DesignA qualitative study using focus group discussions and thematic content analysis.SettingFour health centres in a rural province of Northern Cambodia.ParticipantsTwenty-four focus group discussions were conducted with 85 community health workers in 2019.ResultsCommunity health workers recognised an improvement in neonatal health over time. Key influencers to neonatal health were identified as knowledge, sociocultural behaviours, finances and transport, provision of care and healthcare engagement. Most influencers acted as both barriers and facilitators, with the exception of finances and transport that only acted as a barrier, and healthcare engagement that acted as a facilitator.ConclusionUnderstanding health influencers and care-seeking behaviours is recognised to facilitate appropriate community health programmes. Key influencers and care-seeking behaviours have been identified from rural Cambodia adding to the current literature. Where facilitators have already been established, they should be used as building blocks for continued change.
Highlights
Neonatal mortality poses a significant global burden with 2.5 million neonatal deaths in 2017, one million of which are in the first day of life and 75% within the first week.[1]
The Millennium Development Goals have helped drive a large reduction in under-5 child mortality over the past two decades, improvements in neonatal mortality have been less impressive, with neonatal mortality accounting for 47% of under-5 child mortality globally.[1 2]
A total of 24 focus group discussions (FGDs) were conducted with 85 community health workers (CHWs), 62 women and 23 men, over 4 months which allowed the development and exploration of the following themes: ►► Experience and impact of neonatal health issues. ►► Parental healthcare-seeking behaviours for neonates. ►► Perceived improvements in neonatal health over time and facilitators of these improvements. ►► Persisting barriers to good neonatal health
Summary
Neonatal mortality poses a significant global burden with 2.5 million neonatal deaths in 2017, one million of which are in the first day of life and 75% within the first week.[1] the Millennium Development Goals have helped drive a large reduction in under-5 child mortality over the past two decades, improvements in neonatal mortality have been less impressive, with neonatal mortality accounting for 47% of under-5 child mortality globally.[1 2] Over 90% of neonatal deaths globally are in low/middle- income countries (LMICs), with the majority attributable to premature birth, intrapartum complications and infection.[1 3]
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