Newborn Danger Signs Research Articles

Involving men in pregnancy: a cross-sectional analysis of the role of self-efficacy, gender-equitable attitudes, relationship dynamics and knowledge among men in Kinshasa

BackgroundAlthough male participation in maternal health has gained increasing recognition and support over the years, little is known about male involvement during pregnancy in the Democratic Republic of the Congo. This paper identified male involvement patterns during pregnancy and evaluated their associations with pregnancy and birth preparedness knowledge, gender-equitable attitudes, self-efficacy, and co-parental relationship factors. Lastly, it explored the moderating effect of gender-equitable attitudes and intimate partner violence on the association between relationship satisfaction and male involvement.MethodsData from the 2018 Momentum baseline study were analyzed to determine the predictors of involvement. Factor analysis was used to create male involvement indices for antenatal carebirth preparedness and shared decision making. The sample consisted of 1,674 male partners of nulliparous pregnant women who were 6 months pregnant at baseline.ResultsMale involvement in individual pregnancy-related activities was low, ranging from 11% (finding a blood donor) to 49% (saving money during emergencies). Knowledge of the number of antenatal care visits, birth preparedness steps, and newborn danger signs were positively associated with involvement in antenatal care/birth preparedness activities while knowledge of antenatal care benefits was positively associated with involvement in shared decisions. Increasing relationship satisfaction and self-efficacy were associated with antenatal care/birth preparedness involvement and for shared decisions, a positive association with gender-equitable attitude and a negative association with self-efficacy were observed. Moderation effects were also detected.ConclusionsThe findings suggest that male involvement is multifaceted and factors influencing involvement vary depending on the type of involvement. Addressing these factors can improve male participation in maternal health.

A Comparative Study to Assess the Knowledge and Health Seeking behavior regarding Danger Signs in Newborns among Primi mothers in a selected Urban and Rural Area of Bhilai, (C.G)

This study was conducted with the objectives to assess the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas and to compare the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas And also to correlate knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas and to prepare a booklet regarding danger sign in identification and management of newborn danger signs for mothers. Keeping in view the objective of the study the research design selected for the present study is comparative research design to assess the knowledge and health seeking behaviors regarding danger signs in newborns. The sample size is, 100 primi mothers, 50 each from urban and rural areas. A purposive sampling technique was used to assess the knowledge of primi mothers regarding newborn danger signs. Overall analysis shows that in urban area majority 90% had good knowledge, 10% had average knowledge and none of them had poor knowledge. In rural area majority of mothers i.e., 96% had poor knowledge, 4% had average knowledge and none of them had good knowledge. and also there is significant difference between health seeking behaviours of mothers in urban and rural areas regarding danger signs in newborn. In urban area mean, mean score %, SD, CV of knowledge is 170.56, 87.02, 7.6, and 4.4 respectively. Whereas mean, mean score %, SD, CV of health seeking behavior is 55.96, 93.2, 4.9 and 8.7 respectively. In rural area mean, mean score%, SD, CV of knowledge is 107.96, 62.6, 6.3 and 5.8 respectively. Whereas mean, mean score %, SD, CV of health seeking behavior is 15.34, 55.5, 3.05 and 19.8 respectively. Findings shows that there is significant difference between the level of knowledge as well as health seeking behaviour in urban and rural area regarding danger signs in newborn among primi mothers.

POSTNATAL MOTHERS: KNOWLEDGE OF NEWBORN DANGER SIGNS

Postnatal mothers play a crucial role in the care and well-being of their newborns. Having knowledge about the danger signs that may indicate potential health issues in newborns is essential for early detection and timely intervention. This knowledge can help postnatal mothers ensure the health and safety of their babies. One important aspect of postnatal care is educating mothers about the danger signs that may arise in their newborns. These danger signs can vary from mild to severe and may indicate underlying health conditions that require immediate medical attention. By recognizing these signs, postnatal mothers can seek appropriate medical help and prevent complications. Some common danger signs in newborns include difficulty breathing, persistent high fever, severe jaundice, poor feeding or inability to suckle, persistent vomiting, excessive sleepiness or lethargy, and abnormal movements or seizures. These signs can be indicators of serious health conditions such as respiratory distress, infections, jaundice, or neurological problems.

Level of knowledge about neonatal danger signs and associated factors among postpartum mothers in public hospitals, northeastern Ethiopia

BackgroundKnowing and seeking medical attention for neonatal danger signs has many benefits for reducing neonatal morbidity and death. Despite numerous interventions that have been made to raise mothers’ awareness about neonatal danger signs, the desired level of knowledge has not yet been reached in Ethiopia. ObjectiveTo assess the level of knowledge of neonatal danger signs and associated factors among postpartum mothers in public hospitals in the Eastern Amhara region, northeastern Ethiopia. MethodsA hospital-based cross-sectional study was conducted in four government hospitals between January 10, 2023, and February 10, 2023.421 participants in the study were selected using a systematic random sampling technique. Face-to-face interviews, observation, and chart reviews were used to collect the data. The association was discovered through multivariate logistic regression analysis. ResultOnly 36.6% (154) of mothers were knowledgeable about newborn danger signs in this study. Mothers who had higher institution status [(adjusted odds ratio) AOR = 3.355, 95% CI (1.751, 6.428)]; who were civil servants or a private employer [AOR = 2.986, 95% CI (1.822, 4.892)] and [AOR = 2.544, 95% CI (1.269, 5.138)]; and who had counseling about breastfeeding [AOR = 2.614, 95% CI (1.695, 4.029)] were positive predictors of awareness of neonatal danger signs. ConclusionIn this study, the level of mothers' awareness of newborn danger signs was low and required more effort. Moreover, mothers who were educated, worked as civil servants or private employers, had a family size of 4–6, and received breastfeeding counseling were linked to mothers’ good awareness of newborn danger signs. As a result, intensive community and facility-based health promotion activities on newborn danger signs should be strengthened, with special emphasis on uneducated and housewife mothers and breastfeeding counseling sessions.

Effectiveness of Structured Teaching Programme on Knowledge of Postnatal Mothers Regarding Danger Signs in New Born in a Selected Hospital, Bangalore

An individual’s physical and mental well-being depends on the correct management of events in the perinatal period. The involvement of mothers and community health workers in detecting and assessing the danger signs in newborns is significant. Objectives: To evaluate the effectiveness of a structured teaching programme on danger signs in newborns. Research Design: Pre-experimental research design, one group pre-test and post-test were adopted, whereas 80 post-natal mothers were adopted. Method: Non-probability purposive sampling technique. Data Collection Tool: Baseline variables are assessed. A structured questionnaire was used to assess mothers' knowledge regarding danger signs in newborns. Result: Structured teaching programme was found to be effective in increasing the knowledge scores - pre-test mean score was 10.70 + 2.73, whereas the post-test mean score was 14.05 +-1.59. It was found to be statistically significant at p<0.001. Conclusion: It also stressed the need for introducing such teaching programmes among post-natal mothers to identify and reduce the occurrence of danger signs in newborns as early as possible.

Effect of post-discharge postnatal educational intervention on postnatal practices among low-income primiparas in Nairobi informal settlements, Kenya: a post-test quasi-experiment.

informal settlements exhibit disproportionately worse maternal and newborn outcomes. Postnatal care (PNC) is a high-impact intervention for populations contributing to higher mortalities. Postnatal education is crucial to adopting evidence-based postnatal practices (PNPs) thus its post-discharge reinforcement is vital for low-income primiparas. This study aimed to determine the effect of post-discharge follow-up postnatal education intervention (PNE) on the adoption of recommended PNPs among low-income primiparas. quasi-experimental study in Nairobi informal settlements with 118 primiparas discharged early after normal delivery on each arm. Facility and demographic data collected using an interviewer-administered questionnaire. Study arm received the intervention for 6 weeks in addition to routine PNC while control received routine PNC only. An interviewer-administered exit questionnaire was applied after 6 weeks. Focus group discussions were conducted for qualitative data then analyzed thematically. SPSS used to analyze quantitative data then descriptive statistics, t-tests, Chi-square, Mann-Whitney, and multiple linear or logistic regressions derived. PNPs composed of health-seeking for maternal and newborn danger signs, self and baby care practices, and utilization of PNC contacts. the intervention was a positive predictor of adoption of composite PNPs (β=0.26, p=0.00), self-care practices (β=0.39, p=0.00) and mothers' two weeks PNC contact (OR=4.64, p=0.00, 95% CI=1.9-11.2). Neither a significant predictor of health-seeking for maternal (β=-0.11, p=0.31) nor newborns danger signs (β=-0.04, p=0.73) though inversely related. No influence on baby care practices, two weeks of newborn contact and six weeks contact for the dyad. Multi-pronged approaches are appreciated. follow-up post-discharge PNE intervention enhances adoption of PNPs among low-income primiparas thus a worthwhile supplement to routine PNC.

Implementing quality-of-care during labour, childbirth, and early postnatal care, northeast Namibia: a quasi-experimental study

Background Attention to quality-of-care is increasing in low- and-middle-income countries. Nevertheless, few studies exist on the impact of these approaches to caregiving. This paper presents results on the quality-of-care mothers and neonates receive during labour, childbirth, and early postnatal care, pre-and-post-implementation of the World Health Organization/United Nations Children’s Fund/United Population Fund (WHO/UNICEF/UNFPA) quality improvement interventions. Methods A quasi-experimental study design was used to assess the quality-of-care measures/interventions around childbirth and the immediate postnatal care period; we purposively sampled a high-volume hospital, northeast Namibia. Using the Every Mother Every Newborn (EMEN) childbirth quantitative survey questionnaire, we interviewed (pre=100; post=102) women who delivered prior to their discharge home and observed (pre=53; post=60) different women at admission, of which 19 of 53 and 50 of 60, respectively, progressed to deliver on the same day of data collection. Twenty (pre) and 24 (post) staff, and one facility manager (pre-and-post) were also interviewed. Descriptive statistics were used to present results. Results Postintervention, we found improvements in most assessed quality-of-care measures/interventions, e.g., thorough drying (94.7-100%), babies placed skin-to-skin with their mothers (89.5-98%) and assessed for resuscitation (69.8-98%) needs. Monitoring labour using partograph remained low (11.3-19.3%). During admission, women’s history taking (75.5-95%), blood pressure (98.1%-100%), urine testing (77.4-93.3%), foetal heart rate (94.3-100%), abdominal (86.8-100%) and vaginal examinations (96.2-100%) all improved. Yet, quality-of-care gaps were identified for labour monitoring, and routine postnatal care. Less 50% of women received counselling on family planning (5.3-42%), postnatal care (5.3-40%), maternal (0-38%) and newborn (0-40%) danger signs. Women’s satisfaction with information on breastfeeding and post-partum care and hygiene was 48-56.9% and 41-43.0% respectively. Conclusions This is the first study in Namibia to assess pre-and-post implementation of quality-of-care practices around childbirth, and postnatal period. Inconsistency and noteworthy quality-of-care gaps exist in the early postnatal care period. Postnatal care management and interpersonal communication skills trainings are likely to improve and sustain high evidence-based care beyond labour and delivery. The poor quality-of-care practices for labour and postnatal care requires further investigation.

Edukasi Ibu Hamil Trimester III tentang Tanda Bahaya Bayi Baru Lahir di Desa Matang Puntong Kecamatan Samudera Kabupaten Aceh Utara

The neonatal period is the most critical period for the survival of a child. Based on data from the Central Statistics Agency (BPS), infant mortality under five years old in Indonesia reached 28,158 in 2020, while in Aceh in 2020 it was 8 per 1,000 live births with 792 cases of neonatal deaths and 49 cases originating from North Aceh. , with the most causes being pneumonia, namely 30 cases followed by diarrhea with 14 cases. Based on previous research, it was stated that the majority of mothers chose to take action/medication themselves when their children were sick, with the majority choosing to take them to health care facilities. The problem-solving method used in community service activities in Matang Puntong Village, Samudera Subdistrict, North Aceh Regency is to educate through presentations about danger signs for newborns and distributing leaflets and posters containing danger signs for newborns. The entire target audience, namely pregnant women in their third trimester, totaling 11 people attended the activity and there was an increase in the knowledge of the target audience for community service. It can be seen that in the pretest evaluation before participating in counseling activities 9% were in the good category and the post test evaluation score was 91% in the good category. It is important for health workers to continue to provide information about danger signs in newborns as an effort to increase mothers' knowledge so that they can immediately take action on the conditions that occur in their babies

Counselling on newborn danger signs for women in Bahirdar City, northwest Ethiopia: a community-based cross-sectional study

Background/Aims The prevalences of good knowledge and health-seeking practice for newborn danger signs are generally low in Asia and sub-Saharan African countries. There is limited information available about the effect of maternal and child health service use on this issue among mothers in Bahirdar. This study's aim was to assess the effect of service use on knowledge and health-seeking practice related to newborn danger signs among women with infants in Bahirdar. Methods This community-based cross-sectional study involved 392 women with infants aged less than 6 months, who used maternal and child health services in Bahirdar between 10 September and 10 October 2020. Bivariable and multivariable regression were used to identify service use factors associated with health-seeking behaviour and knowledge related to newborn danger signs. Results Most of the participants recognised that frequent vomiting (81.1%), high fever (73.0%) and convulsion (69.9%) were neonatal danger signs. Postnatal care counselling was strongly associated with health-seeking practice (adjusted odds ratio=1.9, P<0.001). Antenatal care counselling was strongly associated with knowledge of newborn danger signs (adjusted odds ratio=1.57, P<0.001). Conclusions The prevalence of maternal knowledge of newborn danger signs was lower compared to the literature. Similarly, the prevalence of health-seeking practice among mothers with an infant with a newborn danger sign was low. Interventions to improve the quality of antenatal and postnatal counselling are recommended.

A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Selected Newborn Danger Signs among Post Natal Mothers in Shubh General Hospital, Jaipur, Rajasthan

A Study to Assess the Effectiveness of Planned Teaching Programme on Knowledge Regarding Selected Newborn Danger Signs among Post Natal Mothers in Shubh General Hospital, Jaipur, Rajasthan

A descriptive analysis of the coverage of newborn care services among women who delivered in health facilities in 17 sub-Saharan African countries

BackgroundSub-Saharan Africa (SSA) has seen an increase in facility-based births over the years. However, the region has the world’s highest newborn mortality rate (42% in 2019). Quality care around the time of birth can avert these deaths. This study examined the newborn care interventions given to women who gave birth in health facilities in 17 countries in SSA.MethodsA cross-sectional population-based study was conducted. We used data from the most recent Demographic and Health Surveys (DHS) conducted in 17 sub-Saharan African countries. We analysed a weighted sample of 226,706 women aged 15–49 years who gave birth in the five years preceding the surveys. We described the coverage of nine newborn care services, namely weighing at birth, breastfeeding initiation within 1 h after birth, skin-to-skin contact, temperature measurement, cord examination, counselling on newborn danger signs, counselling on breastfeeding, breastfeeding observation, and child health assessment before discharge.ResultsOverall, 72.0% (95% CI: 71.1, 72.8) of births occurred in health facilities, ranging from 40.0% (95% CI: 38.0, 42.1) in Nigeria to 96.3% (95% CI: 95.4, 97.1) in South Africa. Weighing at birth was the most common intervention (91.4%), followed by health checks before discharge (81%). The other interventions, including those given immediately at birth (breastfeeding and skin-to-skin contact), had suboptimal coverage. For instance, 66% of newborns were breastfed within 1 h after birth, and 56% had immediate skin-to-skin contact. Service coverage varied considerably by country and healthcare provider type.ConclusionsThe majority of the examined services, namely early breastfeeding, skin-to-skin contact, cord examination, temperature measurement, counselling on newborn danger signs, breastfeeding observation, and counselling on breastfeeding, were found to have suboptimal coverage. Even though many pregnant women in SSA give birth in healthcare facilities, some newborns do not always get the care they need to be healthy and live. This is a missed chance to improve newborn health and survival around the time of birth.

Low knowledge of newborn danger signs among pregnant women in Papua New Guinea and implications for health seeking behaviour in early infancy – findings from a longitudinal study

BackgroundGlobally, 2.5 million babies die in the first 28 days of life each year with most of these deaths occurring in low- and middle-income countries. Early recognition of newborn danger signs is important in prompting timely care seeking behaviour. Little is known about women’s knowledge of newborn danger signs in Papua New Guinea. This study aims to assess this knowledge gap among a cohort of women in East New Britain Province.MethodsThis study assessed knowledge of newborn danger signs (as defined by the World Health Organization) at three time points from a prospective cohort study of women in East New Britain Province, factors associated with knowledge of danger signs after childbirth were assessed using logistic regression. This study includes quantitative and qualitative interview data from 699 pregnant women enrolled at their first antenatal clinic visit, followed up after childbirth (n = 638) and again at one-month post-partum (n = 599).ResultsKnowledge of newborn danger signs was very low. Among the 638 women, only 9.4% knew three newborn danger signs after childbirth and only one knew all four essential danger signs defined by Johns Hopkins University ‘Birth Preparedness and Complication Readiness’ Index. Higher knowledge scores were associated with higher gravidity, income level, partner involvement in antenatal care, and education.ConclusionLow levels of knowledge of newborn danger signs among pregnant women are a potential obstacle to timely care-seeking in rural Papua New Guinea. Antenatal and postnatal education, and policies that support enhanced education and decision-making powers for women and their families, are urgently needed.

Mother's care-seeking behavior for neonatal danger signs from qualified providers in rural Bangladesh: A generalized structural equation modeling and mediation analysis.

Neonatal deaths contribute to nearly half (47%) of under-five mortality globally and 67% in Bangladesh. Despite high neonatal mortality, care-seeking from qualified providers for newborn danger signs remains low. Identification of direct and indirect factors and their pathways affecting care-seeking will help to design a well-targeted intervention. This study assessed the direct, indirect, and total effect of the predictive factors on neonatal care-seeking in Bangladesh. This was a cross-sectional baseline household survey conducted in 14 districts of Bangladesh in 2019 with 17,251 recently delivered women (RDW) with a live birth outcome in the preceding 15 months. We used a two-stage stratified cluster sampling process to select the samples from 14 districts. We investigated the inter-relationship of maternal background characteristics, maternal health utilizations, child/neonate factors, health service delivery-related factors and newborn danger sign knowledge with newborn care-seeking practices and estimated the direct, indirect, and total effects using Generalized Structural Equation Modeling (GSEM) and mediation analysis. p-value = 0.05 was considered statistically significant. The result of the mediation analysis was reported in Log Odds (LOD). The positive LOD (LOD > 0) implies a positive association. Half of the mothers (50.8%) reported a neonatal illness and among them, only 36.5% mothers of sick neonates sought care from qualified providers. Our mediation analysis showed that maternal health utilization factors, i.e., 4 + antenatal care visits (ANC) from a qualified provider (LOD: 0.63, 95% CI: 0.49, 0.78), facility delivery (LOD: 0.74, 95% CI: 0.30, 1.17) and postnatal care (PNC) from a qualified provider (LOD: 0.50, 95% CI: 0.21, 0.78) showed the highest total effect over other factors domains, and therefore, were the most important modifiable predictors for qualified neonatal care-seeking. Other important factors that directly and/or indirectly increased the chance of newborn care-seeking from qualified providers were household wealth (LOD: 0.86, 95% CI: 0.70, 1.02), maternal education (LOD: 0.48, 95% CI: 0.32, 0.63), distance to nearest health facility (LOD: 0.20, 95% CI: 0.10, 0.30), community health worker's (CHWs) home visits during ANC (LOD: 0.24, 95% CI: 0.13, 0.36), neonatal danger sign counseling after delivery (LOD: 0.20, 95% CI: 0.06, 0.34) and women's knowledge of neonatal danger signs (LOD: 0.37, 95% CI: 0.09, 0.64). The inter-relationship and highest summative effect of ANC, facility delivery, and PNC on newborn care-seeking suggested the maternal care continuum altogether from ANC to facility delivery and PNC to improve care-seeking for the sick newborn. Additionally, referral training for unqualified providers, targeted intervention for poorer households, increasing CHWs home visits and neonatal danger sign counseling at the facility and community should also be considered.

Quality of maternal and newborn care in Switzerland during the COVID‐19 pandemic: A cross‐sectional study based on WHO quality standards

To explore quality of maternal and newborn care (QMNC) in healthcare facilities during the COVID-19 pandemic in Switzerland. Women giving birth in Switzerland answered a validated online questionnaire including 40 WHO standards-based quality measures. QMNC score was calculated according to linguistic region and mode of birth. Differences were assessed using logistic regression analysis adjusting for relevant variables. A total of 1175 women were included in the analysis. Limitations in QMNC during the pandemic were reported by 328 (27.9%) women. Several quality measures, such as deficient communication (18.0%, n=212), insufficient number of healthcare professionals (19.7%, n=231), no information on the newborn after cesarean (26.5%, n=91) or maternal and newborn danger signs (34.1%, n=401 and 41.4% n=487, respectively) suggested preventable gaps in QMNC. Quality measures significantly differed by linguistic region and mode of birth. Multivariate analysis established a significantly lower QMNC for women in French- and Italian-speaking regions compared with the German-speaking region. Moreover, in several quality indicators reflecting communication with healthcare providers, women who did not answer the questionnaire in one of the Swiss national languages had significantly worse scores than others. A significant lower QMNC was also found for young and primiparous women and for those who experienced cesarean or instrumental vaginal birth. Women giving birth in Switzerland during the pandemic reported notable gaps in QMNC. Providers should be attuned to women who are younger, primiparous, and those who had an emergency cesarean or instrumental vaginal birth given the lower QMNC reported by these groups. Women who did not respond in a Swiss national language may need improved communication strategies.

Healthcare-Seeking Behavior and Associated Factors for Newborn Danger Signs among Mothers Who Gave Birth in the Last 12 Months in Anlemo District

Background. Healthcare-seeking behavior is referred to as any action taken by individuals who believe they have a health problem or are ill in order to find an appropriate remedy. The aim of this is to assess healthcare-seeking behavior on newborn danger signs and associated factors among mothers who gave birth in the last 12 months in the Anlemo district. Methods. A community-based cross-sectional study was conducted in the Anlemo district from June 15th, 2019 to July 16th, 2019. Data were collected from 421 randomly selected mothers through a face-to-face interview. Data were cleaned and entered into Epi-Data version 3.1, and then, exported to SPSS version 22.0 for analysis. Binary logistic regression withpvalues less than 0.25 was entered into a multivariable logistic regression for analysis. Finally, adjusted odds ratios (AOR) with 95% confidence intervals at apvalue of <0.05 were considered as a statistically significant association with the outcome variable. Results. Among mothers whose newborns faced newborn danger signs, 34.5% (95% CI: 28.7, 40.5%) sought medical attention for newborn danger signs. When mothers were faced with neonatal danger signs, the multivariable logistic regression model identified three independent variables that were associated with their healthcare-seeking behavior. Mothers who had a college degree or above were 6.34 times more likely than mothers who could not read or write to seek medical care (AOR = 6.34, 95% CI: 1.23–32.69). Mothers or healthcare seekers who did not travel a long distance (less than 5 kilometers) to acquire healthcare were 2.53 times more likely than mothers who traveled a long distance (AOR = 2.53, 95% CI: 1.05–6.08), which had a significant association with the dependent variable. Conclusions. In this study, the proportion of mothers seeking care for newborn danger signs was low, and the mothers’ education, time to reach the nearest health facility, and place of delivery were factors of statistical significance with the dependent variable.

Impact of the Momentum pilot project on male involvement in maternal health and newborn care in Kinshasa, Democratic Republic of the Congo: a quasi-experimental study

BackgroundThe World Health Organization recommends that programs that seek to improve maternal and newborn health outcomes actively involve men during pregnancy, childbirth, and postpartum. However, there is little evidence on what strategies work to increase male knowledge of and involvement in antenatal and postnatal care. This study assessed the impact of the Momentum project on male involvement in maternal health and newborn care. The project involved monthly home visits to a cohort of first-time mothers aged 15–24 recruited at six-months gestation and group education sessions for their male partners using the Program P toolkit. Participants were followed-up for 16 months.MethodsThe study used a quasi-experimental design with three intervention and three comparison health zones. Baseline data were collected in 2018 and endline data in 2020. Exploratory factor analysis was used to develop scales of male involvement. We measured the causal influence of Momentum using an intent-to-treat analysis at the health-zone level and a dose–response analysis at the individual level. We used random-effects probit and linear models for outcomes measured at baseline and endline, and treatment effects models with inverse-probability weighting for outcomes measured only at endline. The impact analysis involved 1,204 male partners of first-time mothers with live births.ResultsIntervention health zones were associated with an 18.1 percentage point (95% CI [(10.6, 25.6]) increase in knowledge of three or more obstetric danger signs and a 13.9 percentage point (95% CI [6.3, 21.6]) increase in knowledge of newborn danger signs. Significant increases in male involvement in antenatal care (average treatment effect (ATE) = 0.728, 95% CI [0.445, 1.010]), birth planning (ATE = 0.407, 95% CI [0.157, 0.657]), and newborn care (ATE = 0.690, 95% CI [0.359, 1.021]) were found. The magnitude of Momentum’s impact increased steadily with the number of prenatal home visits and was statistically significant for all behavioral outcomes except shared decision making. Exposure to both home visits and group education sessions during the prenatal period had a significant impact on all outcomes relative to no exposure.ConclusionsThe study demonstrated the effectiveness of Momentum on male involvement in maternal health and newborn care.

The delivery of essential newborn care in conflict settings: A systematic review.

Although progress has been made over the past 30 years to decrease neonatal mortality rates, reductions have been uneven. Globally, the highest neonatal mortality rates are concentrated in countries chronically affected by conflict. Essential newborn care (ENC), which comprises critical therapeutic interventions for every newborn, such as thermal care, initiation of breathing, feeding support, and infection prevention, is an important strategy to decrease neonatal mortality in humanitarian settings. We sought to understand the barriers to and facilitators of ENC delivery in conflict settings. We systematically searched Ovid/MEDLINE, Embase, CINAHL, and Cochrane databases using terms related to conflict, newborns, and health care delivery. We also reviewed grey literature from the Healthy Newborn Network and several international non-governmental organization databases. We included original research on conflict-affected populations that primarily focused on ENC delivery. Study characteristics were extracted and descriptively analyzed, and quality assessments were performed. A total of 1,533 abstracts were screened, and ten publications met the criteria for final full-text review. Several barriers emerged from the reviewed studies and were subdivided by barrier level: patient, staff, facility, and humanitarian setting. Patients faced obstacles related to transportation, cost, and access, and mothers had poor knowledge of newborn danger signs. There were difficulties related to training and retaining staff. Facilities lacked supplies, protocols, and data collection strategies. Strategies for improved ENC implementation include maternal and provider education and increasing facility readiness through upgrades in infrastructure, guidelines, and health information systems. Community-based approaches may also play a vital role in strengthening ENC.

Evaluation of the impact of maternal training on knowledge of danger signs in sick newborns and health seeking behaviors among mothers in Enugu, South-East Nigeria: A pre-and-post interventional study

The signs/symptoms of serious illness can be subtle in the first few weeks of life, so close monitoring is essential. The World Health Organization has identified nine “danger signs” that are closely associated with morbidity and mortality if not identified early and treated appropriately. This project was undertaken to assess mothers’ knowledge of these danger signs as well as their health seeking behavior before and after newborn danger sign training. From March to September 2021, this community-based interventional study was conducted among women in two rural communities in Enugu State. An interviewer administered questionnaire was used to assess participants’ knowledge of danger signs and care seeking behaviors before and after training on the danger signs of newborns using videos from the Integrated Management of Childhood Illnesses (IMCI). Three months apart, pre- and post-training data were collected for analysis and comparison using SPSS version 20.0 (Chicago IL). The study enrolled a total of 197 women. Only the number of newborns nursed in the past significantly predicted knowledge of danger signs in the sick newborn (p=0.032) among the socio-demographic indices examined. Prior to training, 47% of respondents could not recall any danger signs offhand, compared to 1.5% after training (p=0.001). Knowledge of up to three danger signs significantly increased after training (p=0.001), as did participants who admitted seeking medical help within 24 hours of noticing any danger signs in their newborn (p=0.043). Our study found that training mothers had a significant impact on their knowledge of danger signs in sick newborns as well as their healthcare seeking behavior. As a result, training and retraining of mothers and/or caregivers may aid in improving newborn care and lowering overall infant mortality.

Prevalence of adequate postnatal care and associated factors in Rwanda: evidence from the Rwanda demographic health survey 2020

BackgroundAlthough quality postnatal care (PNC) is a known significant intervention for curbing maternal and newborn morbidity and mortality, it is underutilized in most developing countries including Rwanda. Thus, it is crucial to identify factors that facilitate or occlude receipt of adequate PNC. This study aimed at assessing the prevalence of adequate PNC content and the associated factors in Rwanda.MethodsWe used weighted data from the Rwanda Demographic and Health Survey (RDHS) of 2020, comprising of 4456 women aged 15–49 years, who were selected using multistage sampling. Adequate PNC was considered if a woman had received all of the five components; having the cord examined, temperature of the baby measured, counselling on newborn danger signs, counselling on breastfeeding and having an observed breastfeeding session. We, then, conducted multivariable logistic regression to explore the associated factors, using SPSS version 25.ResultsOut of the 4456 women, 1974 (44.3, 95% confidence interval (CI): 43.0–45.9) had received all the PNC components. Having no radio exposure (adjusted odds ratio (AOR) =1.41, 95% CI: 1.18–1.68), visited by a fieldworker (AOR = 1.35, 95% CI: 1.16–1.57), no big problem with distance to a health facility (AOR = 1.50, 95% CI:1.24–1.81), and residing in the Southern region (AOR = 1.75, 95% CI: 1.42–2.15) were associated with higher odds of adequate PNC compared to their respective counterparts. However, having no exposure to newspapers/magazines (AOR = 0.74, 95% CI: 0.61–0.89), parity of less than 2 (AOR = 0.67, 95% CI: 0.51–0.86), being a working mother (AOR = 0.73, 95% CI: 0.62–0.85), no big problem with permission to seek healthcare (AOR = 0.54, 95% CI: 0.36–0.82), antenatal care (ANC) frequency of less than 4 times (AOR = 0.79, 95% CI: 0.62–0.85), inadequate ANC quality (AOR = 0.56, 95% CI: 0.46–0.68), and getting ANC in a public facility (AOR = 0.57, 95% CI: 0.38–0.85) were associated with lower odds of adequate PNC.ConclusionsLess than half of the mothers in Rwanda had received adequate PNC, and this was associated with various factors. The results, thus, suggested context-specific evidence for consideration when rethinking policies to improve adequate PNC, including a need for intensified PNC education and counselling during ANC visits, continued medical education and training of PNC providers, and strengthening of maternal leave policies for working mothers.

Exploration of barriers to postnatal care service utilization in Debre Libanos District, Ethiopia: A descriptive qualitative study.

BackgroundIn Ethiopia, postnatal care (PNC) service utilization was low although many interventions had been implemented. Previous studies showed community-/caregiver-related barriers to PNC service utilization, but limited evidence was available on the health facilities and health care provider-related barriers. Therefore, the study was aimed at exploring both community and health care provider-related barriers to PNC service utilization.MethodsA descriptive qualitative study was conducted at Debre Libanos District, Ethiopia, from 11 March to 7 April 2019. A purposive sampling technique was used to recruit study participants among recently delivered women (<2 months), health care providers, and community members. A total of five in-depth interviews, 12 key informant interviews, and four FGDs were conducted. Data were audio-recorded, transcribed verbatim, and translated, and inductive thematic analysis was used to analyze the data using the atlas ti.7.1 software.ResultsA total of 51 participants were involved in the study. The findings were organized into two major themes: (1) Community/caregiver-related barriers to PNC service utilization: lack of awareness about PNC, its importance, and schedules; lack of awareness about postnatal danger signs, sociocultural and religious beliefs, topographical and transportation problems, non-functionality of the health developmental armies (HDA); (2) health facility and health care provider-related barriers to PNC service utilization: poor supportive supervision and monitoring, lack of health extension workers' (HEW) commitment, lack of an organized system to notify delivery to HEW, shortage of HEWs, the residence of the HEWs, closure of health posts (HP) on working hours, and non-functionality of HPs.ConclusionsThe study findings underscore the need to develop different strategies and take actions. Therefore, the health centers and district health offices should have to assign the required number of HEWs at HPs, regularly supervise and monitor HEWs, and develop an organized system to facilitate early notification of delivery to HEWs. The HEWs should have to live near the HP, re-organize HDAs, create awareness of maternal and newborn danger signs, and conduct social and behavioral change communications to increase the health-seeking behavior of community members for utilizing PNC services.