Knowledge, Beliefs, and Practices around Newborn Resuscitation in Hilly Tribal Homebirth Settings: A Qualitative Observational Study

Abstract

Objective The study explores home-based newborn resuscitation methods among the Porja hilly tribe in Andhra Pradesh, India. Methods This study was community-based qualitative observational study conducted between October 2021 and March 2022 at 3 intervals. Among the 28 homebirths, 13 were saved with home-based newborn resuscitation methods. The role of traditional birth attendants to save newborn life were found to be highly appreciable. To document its importance, 28 in-depth interviews (IDIs) and two focus group discussions (FGDs) were employed in the study. The participants were 28 mothers of neonates including 13 mothers whose newborns’ first breaths were initiated with different cultural methods and were purposively selected for the IDIs. The data was cross-checked with five untrained traditional birth attendants and 12 elderly female members involved in home deliveries to manage the newborns’ lives. Data collection was carried out using a semi-structured questionnaire on traditional practices, which measured demographic characteristics and women’s perceptions and practices of home-based newborn resuscitation methods. Results The materials used in neonatal awakening were loud sounds with heavy metals, splattering water, thumb pressures on the forehead, chest, and soles region. Four themes were generated: (a) newborn resuscitation is not required on crying neonates, (b) newborn resuscitation is required on noncrying neonates, (c) knowledge of loss of first breath in newborns, (d) post-resuscitation care methods. Conclusion Culture-specified newborn health practices and traditional beliefs still play a crucial role in shaping newborn care practices among hilly tribal communities. The qualitative studies on tribal newborn resuscitation are most important to preserve beneficial traditional methods and preventing harmful practices can help improve the health status of tribal newborn babies, where there are inadequate neonatal services in poor socio-economical resource settings.