Essential Newborn Care Practices Research Articles

Essential newborn care practices in health facilities of Nepal: Evidence from Nepal Health Facility Survey 2015 and 2021.

Availability of newborn care practices in health facilities (HFs) plays an important role in improving the survival and well-being of newborns. In this paper, we aimed to assess practice of carrying out different newborn care practices among HFs between 2015 and 2021, and associated factors in Nepal. We analyzed data of 621 and 786 HFs offering delivery and newborn care services from Nepal Health Facility Surveys 2015 and 2021, respectively. We summarized categorical variables with a weighted percent and 95% confidence interval (CI). We estimated weighted unadjusted absolute difference in percentage of different newborn care practices between 2015 and 2021, and its 95% CI using binomial regression model. We applied univariable and multivariable logistic regression analysis to determine the factors associated with the availability of all seven newborn care practices. The percentage of HFs carrying out all seven newborn care practices was 50.5% (95% CI: 44.6, 56.3) in 2015 and 83.7% (95% CI: 79.8, 87.0) in 2021 with an overall difference of 33.3 percent points (95% CI: 26.4, 40.1). The proportion of HFs reporting all seven newborn care practices increased significantly between 2015 and 2021 in each all three ecological regions and in provinces except Madhesh and Gandaki. In 2021, private hospitals had lower odds of carrying out all seven newborn care practices compared to federal/provincial hospitals (AOR = 0.26, 95% CI: 0.11, 0.63). Similarly, in 2021, the odds of HFs carrying out all seven newborn care practices was 2.87 (95% CI: 1.06, 8.31) times higher in Sudurpashchim compared to Koshi province. In 2021, HFs carrying out seven newborn care practices did not differ significantly based on ecological belts, quality assurance activities, external supervision, delivery service-related training, and frequency of HF meetings. In conclusion, there has been significant improvement in proportion of facilities carrying out seven essential newborn care practices between 2015 and 2021. Type of facility and provinces were associated with the HFs carrying out seven newborn care practices in Nepal.

IJCM_72A: A study on newborn care practices and associated factors influencing their health in urban slums of Kurnool city, Andhra Pradesh.

Background: Neonate is essential time for child to grow. Worldwide, Neonatal mortality are estimated to be about 3 million due to insufficient care. In 2021, 2.3 million neonates have died in first four weeks of life, roughly 6400 neonatal deaths per day. Lack of knowledge in new born care, inappropriate new born care practices are some of the contributors to neonatal mortality. Newborn care practice interventions can prevent neonatal deaths. Understanding the community and traditional newborn care practices is necessary to implement effective programme for promotion of newborns health. Hence present study was done to describe selected newborn care practices in urban slums of Kurnool. Objectives: To assess Newborn-Care Practices and to determine the relationship between Newborn-Care Practices and selected socio-demographic variables. Methodology: A Community-based, Cross-sectional study was done among 220mothers who were residing in urban slums of Kurnool City, Data were collected between October 2023 to November 2023 using Semi-structured questionnaire by Simple Random sampling technique. IEC permission was obtained. Written informed consent was obtained from participants. Data were analyzed using SPSS-Version23. Results: Mothers who were practicing delayed-bathing were observed in the age group 18-24 years 135(61.36%)followed by 25-30 years 60(27.2%),the difference was statistically significant(x2=9.84)(p=0.043),Safe cord care practices were observed more among 18-24 years132(60%),it was found to be statistically significant(x2=23.5)(p=<0.001). Early initiation of breast feeding was more common among age group 18-24 years93(42.2%), it was found to be statistically significant(x2=6.51)(p=0.039). Conclusion: The practice of essential newborn care still needs to improve in Bareilly; There is strong need to implement community-based interventions to improve the newborn care practices & to reduce the high-risk newborn care practices like unsafe cord care, delayed breast feeding, early bathing, Prelacteal feeding & discarding colostrum need through health workers.

Implementation of a quality improvement initiative for standardising essential newborn care in a teaching public hospital in rural central India

ObjectiveOur aim was to refine the essential newborn care practices by employing the multidisciplinary peer team-led quality improvement (QI) projects.DesignIn 2017, concerning the same, the department focused on early initiation...

Theory-based development of a tailored implementation strategy tool to promote Early Essential Newborn Care practice: A protocol

ObjectivesWe aimed to develop an implementation tool that could help healthcare professionals identify modifiable factors and develop tailored implementation strategies to promote the implementation of Early Essential Newborn Care (EENC) under the guidance of the Consolidated Framework for Implementation Research-Expert Recommendations for Implementing Change (CFIR-ERIC). Methods and analysisThis theory-informed implementation study consists two phases. In Phase 1, an exploratory sequential design mixed-methods study will be used to explore the barriers and facilitators to implementing EENC. The qualitative results will be analyzed using NVivo 12.0, underpinned by the Consolidated Framework for Implementation Research (CFIR), whereas the quantitative results being achieved through questionnaires and analyzed using SPSS26.0. In Phase 2, based on the findings of Phase 1, a tailored EENC implementation strategies tool will be developed through iterative expert consultations utilizing the CFIR-ERIC tool and the Implementation Research Logic Model (IRLM).

Practices of essential newborn care endorsed for every newborn and interventions recommended for pre-term babies in selected government hospitals of Colombo District, Sri Lanka

Introduction: World Health Organization (WHO) has identified essential newborn care interventions to improve the care of every newborn. In 2015, the WHO published evidence-based guidelines to improve pre-term birth. Though Sri Lanka also adheres to these recommendations on interventions to improve pre-term birth outcomes, coverage of them have not yet been assessed for the country and there is no recent assessment of essential newborn care coverage as well.Objectives: To describe the practice of essential newborn care (ENC) for babies born pre-term and WHO recommended interventions to improve pre-term birth outcomes in government hospitals of Colombo District.Methods: A descriptive cross-sectional study with two components was conducted in seven government hospitals with obstetric and neonatal care facilities in Colombo District in 2017-2018. The first component describes the coverage of essential newborn care (ENC) assessed by direct observation among convenient sample of 77 deliveries. The second component assessed the practice of recommended interventions to improve pre-term birth. Data were extracted by pre-intern doctors from the medical records using a checklist on 510 pre-terms. Descriptive analysis was done.Results: In relation to ENC, among 77 deliveries, preparation before delivery was satisfactory and it was >90%. Overall, the practice of immediate newborn care interventions were satisfactory, but a low coverage was found for maternal abdomen delivery 31(40.3%), delayed cord clamping 39 (50.6%), temperature measurement 8(10.4%), educating about vitamin K 29 (37.7%), breastfeeding counselling 40 (51.9%) and delayed weighing 26 (33.8%). Practising recommended pre-term interventions was satisfactory except for the use of magnesium sulphate which was received by only 38 (60.3%) and kangaroo mother care was given for only 74 (57.8%).Conclusions & Recommendations: Most of the ENC practices and adhering to recommended interventions for pre-term were satisfactory except for a few. A refresher course of care for the preterm baby and ENC is recommended to the labour room staff.

Neonatal Care Practice among Nurses Working at both Public and Private Hospitals in Bangladesh

Background: Despite medical advancement, Bangladesh still show high infant mortality rate. Infections, pre-term birth, and birth asphyxia are identified as the three leading causes of neonatal deaths worldwide. Advanced quality care and essential newborn care practices can minimize the mortality as well as the morbidity of neonates. Therefore, this study aimed to examine the neonatal care practice among nurses working at both public and private hospitals in Bangladesh. Methods: A descriptive cross-sectional study was conducted among conveniently selected 117 nurses working at the selected three public and two private hospitals in Bangladesh. A face-to-face interview was carried out through a structured questionnaire containing two domains including the socio-demographic part and the neonatal care-related segment. Descriptive and inferential statistics including frequency, percentage, mean, SD and t-test, and ANOVA were used to analyze the data. Results: The total mean score of neonatal care practice was 46.27±9.22 in public hospital and 50.85±5.03 in Private Hospital. The mean age of participants in public was 32.35 (SD=6.85) and in private hospitals was 29.91(SD=3.69) years. There was a statistically significant positive relationship between number of nurses (r=.834, p<.001), number of bed (r=.559, p<.001), job experience (r=.294, p= .023) and neonatal care practice among nurses in public hospital. There was a statistically significant negative relationship between number of nurses (r=-.812, p<.001), number of beds (r=-.812, p<.001) and neonatal care practice among nurses in private hospitals. Conclusion: It is concluded that the overall neonatal care practice of nurses in Bangladesh is at a satisfactory level. Though private hospital nurses show a higher level than government hospitals with respect to neonatal care practice.

Effect of the Mamás del Río programme on essential newborn care: a three-year before-and-after outcome evaluation of a community-based, maternal and neonatal health intervention in the Peruvian Amazon

Despite remarkable progress in maternal and neonatal health, regional inequalities persist in Peru. In rural areas of Amazonian Loreto, access to quality care is difficult, home births are frequent, and neonatal mortality is high. We conducted a prospective before-and-after study to assess the effect after implementation and over time of a community-based intervention on essential newborn care (ENC). Mamás del Río consists of tablet-enhanced educational home visits by Community health workers (CHW) to pregnant women and mothers of newborns, with supportive training on ENC of traditional birth attendants and facility staff. The study area comprised 79 rural communities of three districts in Loreto. Primary outcomes were ENC practices in home births, secondary outcomes were ENC in facility births as well as healthcare seeking, measured at baseline before and at year 2 and year 3 after intervention implementation. Community censuses included questionnaires to women aged 15-49 years with a live birth. We calculated prevalence of outcomes at each time point and estimated adjusted prevalence differences (PD) between time points using post-estimation based on logistic regression. Following implementation early 2019, 97% of communities had a trained CHW. At year 2 follow-up, 63% (322/530) of women received a CHW visit during pregnancy. Seven out of nine ENC indicators among home births improved, with largest adjusted prevalence differences in immediate skin-to-skin contact (50% [95% CI: 42-58], p<0.0001), colostrum feeding (45% [35-54], p<0.0001), and cord care (19% [10-28], p=0.0001). Improvements were maintained at year 3, except for cord care. At year 2, among facility births only three ENC indicators improved, while more women gave birth in a facility. Sensitivity analyses showed ENC prevalence was similar before compared to after onset of Covid-19 lockdown. ENC practices in home births improved consistently and changes were sustained over time, despite the onset of the Covid-19 pandemic. A community-based approach for behaviour-change in home-based newborn care appears effective. Process evaluation of mechanisms will help to explain observed effects and understand transferability of findings. Grand Challenges Canada and Peruvian National Council of Science and Technology.

Impact of essential newborn care education on knowledge and practice of new-born care among nurses in rural primary health centres in Ebonyi state of Nigeria

Background: This study was designed to determine the level of knowledge and the extent of practice of the components of essential new-born care (ENC), and the effects of a training programme on the knowledge and practice of ENC among nurses in rural primary health cares (PHCs) in Ebonyi state Nigeria. Methods: This study was a one group pre-test and post-test intervention design. The components of ENC considered were: New-born initiation of breastfeeding, thermoregulation, new-born cord care, newborn eye care, initiation of breathing and administration of vitamin K. A neonatal care knowledge and practice assessment (NCKPA) questionnaire tested for validity and reliability, with a Spearman’s correlation coefficient of 0.81, was used for data collection among the (48) available nurses (All female). Results: There was significant improvement in the level of knowledge and extent of practice of the components of ENC following the training programme. Despite the improvement, there were gaps in knowledge and practice of the components of ENC amongst the nurses in rural PHCs and affected were the level of knowledge of eye care 20 (41.6%) pre-intervention, and least knowledge of cord care 35 (72.9%) and eye care 45 (93.8%)-post-intervention. Conclusions: Increase in knowledge corresponded with increase in good practice of ENC. The concern with knowledge transfer and translation of knowledge into practice could be achieved by pre-service and in-service education, update courses and workshops, and this will empower the nurses, getting them familiar with current trends and practices for improved child survival rate.

Education of nurses in rural primary health cares to improve vital care of newborns: A community-based research in Nigeria

This study was designed to ascertain the level of knowledge and the degree of practice of the components of Essential New-born care (ENC), and the effects of a training programme on the knowledge and practice of ENC among nurses in rural Primary Health Cares (PHCs) in South East Nigeria. This study was a one group pre-test and post-test intervention design. The components of ENC considered were: New-Born Initiation of Breastfeeding, Thermoregulation, New-Born Cord Care, Newborn Eye Care, Initiation of Breathing and Administration of Vitamin K. A Neonatal care Knowledge and Practice Assessment (NCKPA) Questionnaire tested for validity and reliability, with a Spearman’s correlation coefficient of 0.81, was used for data collection among the (96) available nurses (All female). There was significant improvement in the level of knowledge and extent of practice of the components of ENC following the training programme. Despite the improvement, there were gaps in knowledge and practice of the components of ENC amongst the nurses in rural PHCs and affected were the level of knowledge of Eye care 40(41.6%) - pre-intervention, and least knowledge of cord care 70 (72.9%) and eye care 90(93.8%) - post-intervention. Increase in knowledge corresponded with increase in good practice of ENC. The concern with knowledge transfer and translation of knowledge into practice could be achieved by pre-service and in-service education, update courses and workshops, and this will empower the nurses, getting them familiar with current trends and practices for improved child survival rate.

Essential Newborn Care Services in Nonpublic Health-Care Facilities in Southeast Nigeria

Background The World Health Organization (WHO) has set some standards of essential newborn care (ENC) with some activities, the implementation of which minimizes the incidence of neonatal morbidity and mortality. This study attempted to assess the practice of ENC services among nonpublic health-care facilities and determinants of adequate ENC practice in southeast Nigeria. Methods This was a cross-sectional descriptive study carried out in 4 of the largest cities in southeast Nigeria. The studied facilities were selected by purposive and convenient sampling method. Scores were assigned to the practice of ENC and computed based on standard validated criteria. Data analysis was done using Epi Info version 7.2 and statistical significance was set at P &lt; .05. Results A total of 77 health facilities in the study area were surveyed. The mean annual birth rate in the surveyed health facilities was approximately 342.2. Majority (64.9%) of the health facilities efficiently executed 3 of the 8 ENC practices while only 27 (35.1%) facilities had good essential newborn practices score. The city where the health-care facilities were located influenced the practice of adequate ENC. A greater proportion of health facilities located in Abakaliki and Awka practiced adequate ENC compared to facilities in Enugu and Nnewi ( P = .001). Conclusion ENC service is poor in nonpublic health-care facilities in southeast Nigeria. Training and retraining of health workers as well as provision of necessary incentives through government-private partnership may help ensure better implementation of ENC in order to reduce neonatal morbidity and mortality in southeast Nigeria.

Findings from a mixed-methods evaluation of a multi-level adolescent and youth reproductive and maternal health intervention in Karnali Province, Nepal

IntroductionAdolescent girls and young women (AGYW) in Nepal have disproportionately poor reproductive and maternal health outcomes. In response, Save the Children, the Nepal government, and local partners designed and implemented Healthy Transitions for Nepali Youth, a multi-level integrated intervention. The intervention aimed to improve reproductive, maternal, and newborn health knowledge, attitudes, and behaviors among AGYW, and address gender attitudes and norms in four districts of Karnali Province, Nepal.MethodsMarried and unmarried AGYW aged 15–24 were engaged in a small group, curriculum-based intervention; husbands and families received home visits, using short videos to catalyze discussion; communities were engaged through dialogue-based activities; and the health system was made more adolescent-responsive through quality assessments, training, and supervision. An external organization conducted a quantitative survey with a sample of 786 AGYW intervention participants at baseline and 565 of the same AGYW at endline. Pooled linear regressions were estimated for each indicator to assess the statistical significance of differences between baseline and endline. Focus group discussions and key informant interviews were conducted with AGYW, husbands, families, community leadership, and program implementers. Data analysis was done through STATA 14th version and NVivo.ResultsThe percentage of AGYW currently using a modern contraceptive method increased significantly, and more AGYW believed that their family was supportive of delaying marriage and motherhood at the endline. Young women’s knowledge of danger signs during labor increased, and there was a significant improvement in essential newborn care practices immediately after birth. AGYW reported shifts towards more gender equitable attitudes and behaviors, including related to decision-making about reproductive and maternal health.ConclusionPositive shifts in reproductive, maternal, and newborn health and gender knowledge, attitudes, and behavior were observed among AGYW, their male partners, and families. The results can inform the design of future interventions to effectively reach this critical population.Trail registrationNot applicable.

Quality of maternal and newborn health care at private hospitals in Iraq: a cross-sectional study

BackgroundApproximately 25% of facility births take place in private health facilities. Recent national studies of maternal and newborn health (MNH) service availability and quality have focused solely on the status of public sector facilities, leaving a striking gap in information on the quality of maternal and newborn care services.MethodsA rapid cross-sectional assessment was conducted in November 2022 to assess the quality of MNH services at private hospitals in Iraq. Multi-stage sampling was used to select 15% of the country’s 164 private hospitals. Assessment tools included a facility assessment checklist, a structured health worker interview tool, and a structured client exit interview tool. Data collection was conducted using KoboToolbox software on Android tablets, and analysis conducted using SPSS v28.ResultsAll hospitals visited provided MNH services and had skilled personnel present or on-call 24 h/day, 7 days/week. Most births (88%) documented between January and June 2022 were cesarean births. Findings indicate that nearly all hospitals have the human resources, equipment, medicines and supplies necessary for quality antenatal, intrapartum and early essential newborn care, and many are also equipped with special units and resources needed to care for small and sick babies. However, while resources are in place for basic and advanced care, there are gaps in knowledge and practice of high-impact interventions that require few or no resources to perform, including skin-to-skin thermal care and support for early initiation of breastfeeding. Person-centered maternity care scores suggest that private hospitals offer a positive experience of care for all clients, however there is room for improvement in provider–client communication.ConclusionsThis assessment highlights the need for deeper dives into factors that underly decisions about how and where to give birth, and both understanding and practice of early essential newborn care and pre-discharge examinations and counseling at private healthcare facilities in Iraq. Engaging private health facility staff in efforts to monitor and improve the quality of maternal and newborn care, with a focus on early essential newborn care and provider–client communication for all clients, will ensure that women and newborns benefit from the best care possible with available resources.

Effects of timed and targeted counselling by community health workers on maternal and household practices, and pregnancy and newborn outcomes in rural Uganda

IntroductionPregnancy and birth-related complications claim the lives of millions of women and newborns every year. Improving their survival chances remains an urgent global challenge, including in Uganda. Community health workers (CHWs) play a crucial role in bridging the gap between the community and the official health system in Uganda. Timed and targeted Counselling (ttC) is an individual-level behavioral change communication method used by CHWs, aimed at pregnant women and caregivers of children under the age of two. AimThis study examined whether the implementation of the ttC intervention by the CHWs was associated with improved household practices and outcomes during the pregnancy and newborn period. MethodsA multi-stage sampling technique was employed with a total of 749 participants in the intervention group (ttC intervention), and 744 participants in the control group (no ttC). Data on quality of maternal and household antenatal care (ANC) and essential newborn care (ENC) practices, as well as on pregnancy and newborn outcomes were collected through questionnaires from May 2018 to May 2020. McNemar’s Chi-square tests were used to compare outcomes before and after implementation, and between the intervention and control group. ResultsResults showed that, compared to baseline, ttC contributed significantly to the demand for quality of service during ANC, ENC and partner involvement in maternal and newborn health. In comparison to the control group, the ttC group showed significantly higher early ANC attendance rates and higher quality of ANC and ENC. ConclusionttC is a comprehensive, goal-driven approach that seems to contribute to the improvement of quality of maternal and household practices, and pregnancy and newborn outcomes in Uganda. Trial registrationPACTR, PACTR202002812123868, registered on 25 February 2020, http://www.pactr.org/PACTR202002812123868.

Newborn Care Practices and Associated Factors Influencing Their Health in a Northern Rural India

In developing countries, neonatal mortality is the most neglected health issue by the health system, leading to its emergence as a public health problem. A study was undertaken to assess the influence of factors and newborn care practices influencing newborn health in the rural area of Bareilly district. The descriptive cross-sectional study was organized in the rural areas of Bareilly. Study participants were selected based on the mothers who gave birth to a baby during the last six months. The mothers who delivered in that area within six months were included and, using the semi-structured questionnaire, data were collected. Data were analyzed using Microsoft Excel and SPSS 2021 version for windows. Out of 300 deliveries, nearly one-quarter of the deliveries, 66 (22%), were happening in homes, and most of the deliveries, 234 (78%), happened in hospitals. It was observed that unsafe cord care practices were observed more among nuclear families, 8 (53.4%), than joint families, 7 (46.6%), and it was found to be statistically insignificant. The Unsafe feed was given 48 (72.7%) more commonly among home deliveries than institutional deliveries 56 (23.9%). Mothers' initiation of delayed breastfeeding was nearly the same in both home and hospital deliveries. Delayed bathing was observed in nearly three-fourths of mothers, 125 (70.1%), aged 24-29 years, followed by 29 (16.8%) in the age period of 30-35 years. The practice of essential newborn care still needs to improve in Bareilly; there is a need to create awareness among the mothers and family members on newborn and early neonatal care aspects, such as promoting exclusive and early initiation of breastfeeding and delayed bathing practices.

Qualitative assessment of family caregiver-centered neonatal education program in Karnataka, India.

Globally 2.5 million newborns die every year before they reach the age of one month; the majority of these deaths occur in low- and middle-income countries. Among other factors, inadequate knowledge and skills to take care of newborns contribute to these deaths. To fill this gap, training patients and family members on the behaviors needed to improve essential newborn care practices at home is a promising opportunity. One program that aims to do this is the Care Companion Program (CCP) which provides in-hospital, skills-based training on care of mothers and newborns to families. This study uses semi-structured interviews to understand how and why knowledge and behaviors of maternal and newborn care behaviors change (or don't change) as a result of CCP sessions and participants' perception of the impact of CCP on change. Interviews focused on knowledge and behaviors around key neonatal and newborn topics and health seeking behaviors for health complications. Forty-two in-depth interviews were conducted among families with recently-delivered babies at their homes from four districts in Karnataka, India. Respondents have a positive perception about CCP, found training useful and appreciated other family members presence during the training. CCP increased knowledge and awareness and provided critical details to key behaviors like breastfeeding. Respondents were more likely to be receptive toward details on already known topics, like hand washing before touching the baby. Awareness increased on newly learned behaviors, like skin-to-skin care, which don't conflict with cultural norms. The CCP did not influence nonrestrictive maternal diet as much, which cultural norms heavily influence. In-hospital family caregiver education programs, like CCP, can positively influence key neonatal behaviors by imparting knowledge and key skills. However, the effect is not universal across health behaviors.

Women's multidimensional empowerment index and essential newborn care practice in Bangladesh: The mediating role of skilled antenatal care follow-ups.

The World Health Organization recommended a set of five neonatal care practices that are most essential for good health of a newborn. As good essential newborn care (ENC) practice reduces the risk of neonatal morbidity and mortality, this paper focuses how women's multidimensional empowerment index is associated with this practice through the skilled antenatal care. To the best of knowledge, no such study has been conducted yet. The composite index of women's multidimensional empowerments was constructed using family decision, intimate partner violence, social status, healthcare access and economic status of women; and skilled antenatal care was defined if a pregnant woman received eight or more checkups during pregnancy from skilled health professionals. Data extracted from Bangladesh Demographic and Health Survey, 2017-18 have been utilized in the study. A total of 2441 mothers have been considered who delivered their last live birth at home within three years preceding the survey. A mediation analysis was performed considering the structural equation modeling to find out the adjusted association of women's empowerment on both skilled antenatal care and good ENC practice, but the unadjusted associations were also checked using a chi-square test. To test the indirect as well as total effect of women's empowerment through skilled antenatal care on good ENC practice, bias-corrected standard errors were estimated using a bootstrapping sampling. Good ENC practice was considerably low in Bangladesh with 7.6% of newborns receiving the practice. Both adjusted and unadjusted analyses showed the significant association of women's empowerment with both skilled antenatal care and good ENC practice. The study revealed that the indirect effect of high empowerment through skilled antenatal care was greater than its direct effect on good ENC practice. This study explored that the prevalence of good ENC practice can be accelerated through women's empowerment, where skilled antenatal care plays an important mediating role in improving good ENC practice among highly empowered mothers. The study suggests that a woman should follow the latest guidelines recommended by WHO for antenatal care follow-up. Policymakers can modify some of the maternal and child health care interventions based on the research findings.

Essential newborn care practices and associated factors among home delivered mothers in Guto Gida District, East Wollega zone.

Essential Newborn Care is a set of strategic and cost-effective interventions planned to improve the health of newborns through the care they receive from birth up to 28 days. In the current study area, little is known about the prevalence of essential newborn care practices and its associated factors. This study was aimed to assess the prevalence of essential newborn care practice and its associated factors among home-delivered mothers in Guto Gida district, western Ethiopia. A community-based cross-sectional study was conducted in Guto Gida district from September 5 to 15, 2020. Data were collected by interviewing 601 systematically selected home-delivered women. Descriptive statistics were employed to describe frequency and percent. Binary logistic regression analysis was employed to identify candidate variables for the final model. Variables with p-value less than 0.25 at bivariate logistic regression were considered as the candidate variable and entered into multivariable logistic regression model. Finally, multivariable logistic regression was employed to identify associated factors at p-value less than 0.05, and the strength of association was described by adjusted odds ratios with 95% CI. The study shows that the level of essential newborn care practices was 168 (28%) (23.9-31.4). In this study, women in the first wealth quantile (AOR [95% CI] = 0.64 [0.34-0.97]), women who had one live birth (AOR [95% CI] = 0.51 [0.22-0.87]), women who lost their neonate before the study period (AOR [95% CI] = 0.11 [0.05-0.22]) were less likely to practice essential newborn care. Women who were advised on essential newborn care practice during a home visit by health extension workers (AOR [95% CI] = 3.45[1.56-7.26]), women who attended antenatal care during their current pregnancy (AOR [95% CI] = 1.79 (1.21-3.36]), and women who were attended at their birth by health extension workers (AOR [95% CI] = 3.29 [2.13-5.94]) were more likely to practice essential newborn care. In this study, the prevalence of essential newborn care practice was low (28%), as compared with the World Health Organization recommendation that it should be 100%. The wealth quantile, number of live births, home visits by health extension workers, antenatal care, birth attendant, and neonatal death were independent predictors of essential newborn care practices.

Assessment of knowledge and practice of gynecology/obstetrics residents and midwives towards essential newborn care At Tikur Anbessa Specialized Hospital, Addis Ababa University, Ethiopia

Background: A time-bound and chronologically ordered series of medical interventions that a baby receives at birth are referred to as the "essential newborn protocol." This period of immediate care is critical for the babies' subsequent well-being and adaptation. However, there are still reports of health workers lacking good knowledge and practice with newborn care, which was not investigated in our hospital. &#x0D; Methods: A hospital-based cross-sectional study was conducted in TASH with 114 selected gynecology and obstetrics residents and midwives. Using the SPSS version 25 software package, continuous data were described using the mean and standard deviation, while categorical data were de-scribed using frequency and percentage. To identify factors related to knowledge and practice, multivariable binary logistic regression analyses were used. &#x0D; Result: Eighty-eight residents and 26 midwives were included. Nearly a quarter (24.6%) of participants had good knowledge about essential newborn care. Regarding knowledge level by profession, 31.8% of the residents had good knowledge of essential newborn care, and all the midwives had poor knowledge. The odds of having good knowledge of ENC were 96.3% lower for first-year residents and 90.5% lower for second-year residents as compared to year four. Untrained participants had an 84 percent lower chance of having good knowledge of essential newborn care than trained participants. Regarding practice level by profession, more than two-thirds of 68 (77.3%) residents and 21 (80.8%) midwives had sufficient skill in essential newborn care. &#x0D; Conclusion: A substantial number of healthcare providers lacked essential newborn care knowledge and practice. The availability of service or on-the-job training, as well as the year of residency, were factors influencing newborn care knowledge. In-service training, encouraging supervision, and provisions should be reinforced to improve newborn care activities.

Prevalence of essential newborn care in home and facility births in the Peruvian Amazon: analysis of census data from programme evaluation in three remote districts of the Loreto region

Essential newborn care (ENC) covers optimal breastfeeding, thermal care, and hygienic cord care. These practices are fundamental to save newborn lives. Despite neonatal mortality remaining high in some parts of Peru, no comprehensive data on ENC is available. We sought to estimate the prevalence of ENC and assess differences between facility and home births in the remote Peruvian Amazon. We used baseline data from a household census of rural communities of three districts in Loreto region, collected as part of the evaluation of a maternal-neonatal health (MNH) programme. Women between 15 and 49 years with a live birth in the last 12 months were invited to complete a questionnaire about MNH-related care and ENC. Prevalence of ENC was calculated for all births and disaggregated by place of birth. Adjusted prevalence differences (PD) were post-estimated from logistic regression models on the effect of place of birth on ENC. All 79 rural communities with a population of 14,474 were censused. Among 324 (>99%) women interviewed, 70% gave birth at home, most (93%) without skilled birth assistance. Among all births, prevalence was lowest for immediate skin-to-skin contact (24%), colostrum feeding (47%), and early breastfeeding (64%). ENC was consistently lower in home compared to facility births. After adjusting for confounders, largest PD were found for immediate skin-to-skin contact (50% [95% CI: 38-62]), colostrum feeding (26% [16-36]), and clean cord care (23% [14-32]). ENC prevalence in facilities ranged between 58 and 93%; delayed bathing was lower compared to home births (-19% [-31 to-7]). Low prevalence of ENC practices among home births in a setting with high neonatal mortality and difficult access to quality care in facilities suggests potential for a community-based intervention to promote ENC practices at home, along with promotion of healthcare seeking and simultaneous strengthening of routine facility care. Grand Challenges Canada and Peruvian National Council of Science, Technology, and Technology Innovation.

Early newborn bathing and associated factors among mothers in Afar Region, Northeast Ethiopia

Delaying newborn bathing for 24 h after childbirth protects the baby from hypothermia, infection and hypoglycaemia and provides an opportunity for mother-baby emotional bonding. However, no previously published study has investigated the early newborn bathing practices of pastoral mothers in Ethiopia. This study aims to investigate early newborn bathing and associated factors among mothers in Afar Region, Northeast Ethiopia. Institution-based cross-sectional study was conducted from May to June 2021. A systematic random sampling technique was used to recruit 386 mothers, and the data collection was performed using an interviewer-administered questionnaire. Multivariable logistic regression modelling was used to examine the association between explanatory variables (including sociodemographic, obstetric, health service and health literacy factors) and early newborn bathing. The overall prevalence of early newborn bathing among postpartum mothers was 73.1% with a 95% confidence interval (CI) from 68.4 to 77.5%. Mothers who attained college or higher education [adjusted odds ratio (AOR) = 0.21; 95% CI 0.06-0.66], those who were from urban areas (AOR = 0.19; 95% CI 0.09-0.42) and those who gave birth using operational delivery (e.g. caesarean section and instrumental delivery) (AOR = 0.01; 95% CI 0.01-0.04) were less likely to practice early newborn bathing. The practice of early newborn bathing was unacceptably high in pastoral communities of the Afar Region. There is a need for interventions specifically targeting at uneducated and rural mothers as part of the implementation to improve the essential newborn care practices of mothers in pastoral communities in Ethiopia.