Abstract
Proper utilization of skilled care services in neonatal illnesses is crucial to reduce neonatal morbidity and mortality. The study aimed to evaluate the level and factors associated with seeking care from skilled healthcare service providers for reported neonatal illnesses in rural Matlab, Bangladesh. This community based cross-sectional study was based on data from a randomly selected sample comprised of 2223 women who delivered live-born babies in 2014. Data were collected from June to October 2015 through a structured questionnaire. We used a multivariable logistic regression model and presented the results by adjusted odds ratios (AOR) with 95% confidence intervals (CI). Of the neonates, 1361 (61.2%) suffered from at least one complication, and among these, 479 (35.2%) sought care from skilled healthcare service providers. In the multivariable logistic regression analysis, the participants' husbands' educational level, number of antenatal care visits, and place of childbirth were significantly associated with seeking skilled care for reported neonatal illnesses. The care-seeking from skilled healthcare service providers for neonatal illness was more than two times higher (AOR = 2.26, 95% CI = 1.51-3.39) in the group in which the participants' husband had attended school for more than 10 years as compared to the group in which they had attended school for less than six years. The AORs of seeking skilled care were 1.93 (95% CI = 1.42-2.62) and 2.26 (95% CI = 1.51-3.39) with the mothers receiving two to three and four or more antenatal care services, respectively, compared to the mothers with no or one antenatal care visit. Women who gave birth at a health facility were three times (AOR = 3.24, 95% CI = 2.50-4.19) more likely to seek skilled care for sick neonates compared to those who gave birth at home. The utilization of skilled care for neonatal sicknesses was low in this rural setting in Bangladesh. The participants' husbands' higher school attendance, increased number of ANC visits, and facility delivery were positively associated with care-seeking from skilled healthcare providers for neonatal illness. The husbands with low school attendance should be targeted for intervention, and continue efforts to increase ANC coverage and facility delivery to improve neonatal health in this country's rural area.
Highlights
Care during the neonatal period, the first 28 days of life, is crucial for survival as during the transition from fetal to a complex extra-uterine environment, the newborns are most vulnerable, and their developing organs are not mature enough
In the multivariable logistic regression analysis, the participants’ husbands’ educational level, number of antenatal care visits, and place of childbirth were significantly associated with seeking skilled care for reported neonatal illnesses
The care-seeking from skilled healthcare service providers for neonatal illness was more than two times higher (AOR = 2.26, 95% confidence intervals (CI) = 1.51–3.39) in the group in which the participants’ husband had attended school for more than 10 years as compared to the group in which they had attended school for less than six years
Summary
Care during the neonatal period, the first 28 days of life, is crucial for survival as during the transition from fetal to a complex extra-uterine environment, the newborns are most vulnerable, and their developing organs are not mature enough. In the last two decades, we observed substantial improvement in the reduction of mortality of children under five years. This reduction is not evenly spread across all age groups. While the decrease in mortality in the age groups of one to 11 months and one to four years were 51% and 60%, respectively, the neonatal mortality reduced by only 41%. All countries, including Bangladesh, aim to reduce neonatal mortality to less than 12/ 1,000 live births [5]. Proper utilization of skilled care services in neonatal illnesses is crucial to reduce neonatal morbidity and mortality. The study aimed to evaluate the level and factors associated with seeking care from skilled healthcare service providers for reported neonatal illnesses in rural Matlab, Bangladesh
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