Abstract
BackgroundSkin-to-skin contact (SSC) practice improves newborn survival and child development through preventing hypothermia in newborns, improving early initiation of breastfeeding practice, and strengthening mother-child bonding. Despite having numerous benefits, it is one of the least practiced interventions in low and middle-income countries (1 to 74%). In Bangladesh, the prevalence of SSC was 26% in 2014. In this study, we aimed to estimate the prevalence of SSC in the study districts and identify factors that facilitate or inhibit SSC practice so that context-specific recommendations can be made to advance the use of this intervention.MethodsWe used baseline household survey data of USAID’s MaMoni MNCSP project conducted in 10 districts of Bangladesh in 2019. Our analysis included 13,695 recently delivered women (RDW) with a live birth outcome. Our primary outcome was the mother’s reported practice of SSC. We examined various antepartum, intrapartum, newborn, and sociodemographic factors associated with SSC using a multivariable generalized linear model. Our findings were reported using adjusted Prevalence Risk Ratios (aPRRs) and 95% Confidence Intervals (CIs).ResultsOverall, 28% of RDW reported practicing SSC across the 10 surveyed districts. Our multivariable analysis showed that public facility delivery (aPRR 2.01; 95%CI: 1.80, 2.26), private facility delivery (aPRR 1.23; 95%CI: 1.06, 1.42) and ≥ 4 antenatal care (ANC) visits at least one from a medically trained provider (MTP) (aPRR 1.17; 95%CI: 1.03, 1.26) had a significant positive association with SSC practice. Caesarean section (aPRR 0.64; 95%CI: 0.56, 0.73) had a significant negative association with SSC practice compared to vaginal births. We also found a significant positive association of SSC practice with mothers’ who perceived the birth size of their baby to be small, mothers with a higher education level (≥10 years), and mothers from households in the highest wealth quintile.ConclusionsThe prevalence of SSC is very low in the surveyed districts of Bangladesh. Considering the factors associated with SSC, relevant stakeholders need to increase their efforts on improving ANC and facility delivery coverages as well as improving SSC practice in the facilities especially after caesarean deliveries. Countries with a high burden of home deliveries, also need to emphasize community-based interventions and increasing coverage of skilled birth attendance for improving this life-saving intervention.
Highlights
Skin-to-skin contact (SSC) practice improves newborn survival and child development through preventing hypothermia in newborns, improving early initiation of breastfeeding practice, and strengthening mother-child bonding
The survey collected information from 14,982 recently delivered women (RDW) who had a birth outcome in the preceding 15 months using a structured questionnaire adapted from the Bangladesh Demographic Health Survey (BDHS) 2017 [18]
The majority of the mothers who delivered in the private facilities reported cesarean deliveries (85%) while less than one-third of mothers who delivered in the public facilities reported having a cesarean delivery (Fig. 1)
Summary
Skin-to-skin contact (SSC) practice improves newborn survival and child development through preventing hypothermia in newborns, improving early initiation of breastfeeding practice, and strengthening mother-child bonding. Despite making significant improvements in the reduction of mortality among under-five children, the reduction of mortality in the neonatal period remains an unfinished Millennium Development Goal (MDG) agenda for many low and middle-income countries [2,3,4,5]. The World Health Organization (WHO) recommends a set of simple life-saving interventions, known as essential newborn care (ENC) practices [7, 8]. The core interventions included in ENC are early initiation of breastfeeding, thermal regulation (drying/wrapping the baby, skin-to-skin contact (SSC), and delayed bathing), and appropriate cord care [7, 8]. A significant positive association of SSC has been shown with thermal regulation and early initiation of breastfeeding practice [9]
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