Care of the neonate and management of neonatal jaundice as practised by Yoruba traditional healers of Nigeria.

Abstract

In 1950 and 1958 it was reported that infant mortality rates due to neonatal tetanus ran 90% and 89.9% respectively in Ibandan Nigeria. Similarly figures for neonatal jaundice are alarmingly high. The etiologic factor improper care of the babys umbilical cord and improper care of the neonate by herbalist midwives has not changed in a decade. Since 80% of Nigerians live in rural areas and give birth in midwives homes a study was undertaken to explore how the midwife/herbalist handles the delivery. 165 Yoruba herbalists were randomly selected from 31 towns and villages in the geographical area occupied by the Yoruba. They were asked to fill out an open ended questionnaire on what instruments they use in cutting the cord how soon after the birth of the baby the cord is cut where the cord is tied and the materials used in dressing the cord. 62.2% of Yoruba traditional healers responded that they cut the cord with broken bottles rafia blades or bamboo splits. 18.9% used unsterile knives. 30% of the respondents did not tie the cord. 20.7% stated they used herbal medicine to dress the cord. Many of these medicinal herbs contain bird droppings or ashes. 77% recognized neonatal jaundice in the children they delivered. 69% of the herbalist midwives advised women to give their jaundiced children herbal concoctions of drugs soap and purgatives. It is well recognized that neonatal tetanus is caused by the use of unsterile instruments and dressings. Herbal drugs given to a newborn infant can produce severe diarrhea or aggravate the jaundice. 100% hospital confinement would eliminate all causes of neonatal tetanus. Education of the midwife/herbalist in aseptic techniques and cord management would substantially cut down on cases of neonatal jaundice and tetanus.