Abstract
BackgroundBeneficial newborn care practices can improve newborn survival. However, little is known about the factors that affect adoption of these practices.MethodsCross-sectional study conducted among 1,616 mothers who had delivered in the past year in two health sub-districts (Luuka and Buyende) in Eastern Uganda. Data collection took place between November and December 2011. Data were collected on socio-demographic and economic characteristics, antenatal care visits, skilled delivery attendance, parity, distance to health facility and early newborn care knowledge and practices. Descriptive statistics were computed to determine the proportion of mothers who adopted beneficial newborn care practices (optimal thermal care; good feeding practices; weighing and immunizing the baby immediately after birth; and good cord care) during the neonatal period. We conducted multivariable logistic regression to assess the covariates of adoption of all beneficial newborn care practices. Analysis was done using STATA statistical software, version 12.1.ResultsOf the 1,616 mothers enrolled, 622 (38.5 %) were aged 25-34; 1,472 (91.1 %) were married; 1,096 (67.8 %) had primary education; while 1,357 (84 %) were laborers or peasants. Utilization of all beneficial newborn care practices was 11.7 %; lower in Luuka (9.4 %, n = 797) than in Buyende health sub-district (13.9 %, n = 819; p = 0.005). Good cord care (83.6 % in Luuka; 95 % in Buyende) and immunization of newborn (80.7 % in Luuka; 82.5 % in Buyende) were the most prevalent newborn care practices reported by mothers. At the multivariable analysis, number of ANC visits (3-4 vs. 1-2: Adjusted (Adj.) Odds Ratio (OR) = 1.69, 95 % CI = 1.13, 2.52), skilled delivery (Adj. OR = 2.66, 95 % CI = 1.92, 3.69), socio-economic status (middle vs. low: Adj. OR = 1.57, 95 % CI = 1.09, 2.26) were positively associated with adoption of all beneficial newborn care practices among mothers.ConclusionAdoption of all beneficial newborn care practices was low, although associated with higher ANC visits; middle-level socio-economic status and skilled delivery attendance. These findings suggest a need for interventions to improve quality ANC and skilled delivery attendance as well as targeting of women with low and high socio-economic status with newborn care health educational messages, improved work conditions for breastfeeding, and supportive policies at national level for uptake of newborn care practices.
Highlights
Beneficial newborn care practices can improve newborn survival
Forty four per cent (726) of the mothers were of parity 5+; 1,583 (98 %) reported antenatal care attendance; 979 (61.8 %) attended ANC for 3-4 times while 889 (56.2 %) had their first ANC visit in trimester 2
Our findings suggest a need for provision of quality antenatal care, promotion of ANC attendance up to the 4th visit, quality skilled delivery services and skilled delivery attendance in order to increase the proportion of mothers who can and are able to adopt beneficial newborn care practices for the benefit of their babies’ growth and survival
Summary
Beneficial newborn care practices can improve newborn survival. little is known about the factors that affect adoption of these practices. The rising numbers of births especially in sub-Saharan Africa have lead to more 1.4 million more child deaths [2]. The precursors of these neonatal deaths have partly been traced back to lack of practice of beneficial newborn care practices and attributable to largely infections, intrapartum birth conditions, and preterm births [3,4,5]. Studies have shown that beneficial newborn care practices at population level can save many newborn lives [11, 17, 18]. These beneficial newborn care interventions are simple, cost effective, and acceptable: a single skilled birth attendant caring can effectively provide many of them for the mother and the newborn and sometimes by the mother herself if taught [1, 16, 19,20,21,22]
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