Abstract
Background or Objectives:The neonatal period, the first 28 days of life, is the most critical period for child survival. In 2017, 214,000 children in Nigeria died during the neonatal period. Newborn care practices play a key role in preventing these deaths. The aim of this study was to examine the association between delivery location and early newborn care in Nigeria.Methods:Data from the 2013 Nigeria Demographic and Health Survey were analyzed. The main exposure variable was delivery location (home, public hospital, public health center/clinic and private hospital/clinic). The outcomes were early initiation of breastfeeding, breastfeeding support, and cord examination. We used multivariate logistic regression to estimate the odds of newborn care.Results:We observed that the prevalence of all three outcome indicators was low. After adjusting for confounders, birth in public health facilities, compared to home birth, was associated with early initiation of breastfeeding (public hospitals: OR 1.62, 95% CI: 1.29-2.03; public health centers/clinics OR: 1.28, 95% CI: 1.02-1.61). Breastfeeding support and cord examination were each associated with birth in public hospitals only compared to home birth (OR 1.41, 95% CI: 1.09-1.81 and OR 1.41, 95% CI: 1.11-1.79, respectively).Conclusion and Global Health Implications:Early newborn care in Nigeria was suboptimal and the quality of this care varied across delivery locations and birth attendants. Public hospitals had the most favorable newborn care outcomes. Policies and programs to enhance the quality of facility-based early newborn care and promote community-based newborn care could improve neonatal outcomes and reduce overall child mortality in resource-challenged settings.
Highlights
Despite the global progress in the reduction of under-five mortality, the decline in neonatal mortality has been less successful.[1,2] In 2017, of the5.4 million under-five deaths recorded, 2.5 million deaths occurred during the neonatal period.[2]
Stakeholders need to intensify efforts to ensure proper implementation and evaluation of interventions to improve breastfeeding practices, among mothers who deliver their babies at home or in a private health facility
All skilled birth attendants (SBA) need to be adequately trained on providing optimal newborn care, including cord examination
Summary
Despite the global progress in the reduction of under-five mortality, the decline in neonatal mortality has been less successful.[1,2] In 2017, of the5.4 million under-five deaths recorded, 2.5 million deaths occurred during the neonatal period.[2]. International Journal of Maternal and Child Health and AIDS (2020),Vol 9, No 1, 93-102 occur in the first week of life, with approximately one million deaths each occurring on the first day and over the six days, respectively.[4,5] The leading causes of neonatal deaths are preterm birth, delivery-related complications such as birth asphyxia, infections, and birth defects.[6] Most neonatal deaths occur in low- and middle-income countries with the highest burden in sub-Saharan Africa and South Asia Children in these regions are nine times as likely to die within their first month of life compared to children in other regions.[7] Nigeria, like many sub-Saharan African countries, experienced a slight decline in neonatal mortality from 2000-2017 but still accounts for the highest number of neonatal deaths in sub-Saharan Africa.[7] with 214,000 neonatal deaths in 2017, Nigeria is second to India in the number of neonatal deaths.[2]. Newborn care practices play a key role in preventing these deaths.The aim of this study was to examine the association between delivery location and early newborn care in Nigeria
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