Neonatal Danger Signs Research Articles

Mothers’ health-seeking practices and associated factors towards neonatal danger signs in Ethiopia: a systematic review and meta-analysis

BackgroundA decrease in obtaining quality healthcare is a major cause of maternal and newborn deaths in low-income and middle-income countries. Ethiopia has one of the highest neonatal mortality rates. Increasing...

Fathers’ knowledge of neonatal danger signs and its associated factors in Northwest Ethiopia: a community-based cross-sectional study

ObjectiveThis study aimed to assess fathers’ knowledge of neonatal danger signs and their associated factors in Northwest Ethiopia.DesignCommunity-based cross-sectional study.SettingEnarji and Enawga Woreda, Northwest Ethiopia.ParticipantsThe study was conducted on 613...

Digital communication between mothers and community health workers to support neonatal health (CHV-NEO): study protocol for a randomized controlled trial

BackgroundProvision of essential newborn care at home, rapid identification of illness, and care-seeking by caregivers can prevent neonatal mortality. Mobile technology can connect caregivers with information and healthcare worker advice more rapidly and frequently than healthcare visits. Community health workers (CHWs) are well-suited to deliver such interventions. We developed an interactive short message service (SMS) intervention for neonatal health in Kenya, named CHV-NEO. CHV-NEO sends automated, theory-based, actionable, messages throughout the peripartum period that guide mothers to evaluate maternal and neonatal danger signs and facilitate real-time dialogue with a CHW via SMS. We integrated this intervention into Kenya’s national electronic community health information system (eCHIS), which is currently used at scale to support CHW workflow.MethodsThe effect of CHV-NEO on clinical and implementation outcomes will be evaluated through a non-blinded cluster randomized controlled trial. Twenty sites across Kisumu County in Western Kenya were randomized 1:1 to provide either the national eCHIS with integrated CHV-NEO messaging (intervention) or standard of care using eCHIS without CHV-NEO (control). We will compare neonatal mortality between arms based on abstracted eCHIS data from 7200 pregnant women. Secondary outcomes include self-reported provision of essential newborn care (appropriate cord care, thermal care, and timely initiation of breastfeeding), knowledge of neonatal danger signs, and care-seeking for neonatal illness, compared between arms based on questionnaires with a subgroup of 2000 women attending study visits at enrollment in pregnancy and 6 weeks postpartum. We will also determine CHV-NEO’s effect on CHW workflows and evaluate determinants of intervention acceptability, adoption, and fidelity of use through questionnaires, individual interviews, and messaging data.DiscussionWe hypothesize that the CHV-NEO direct-to-client communication strategy can be successfully integrated within existing CHW workflows and infrastructure, improve the provision of at-home essential newborn care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. The intervention’s integration into the national eCHIS tool will facilitate rapid scale-up if it is clinically effective and successfully implemented.Trial registrationClinicalTrials.gov, NCT05187897. The CHV-NEO study was registered on January 12, 2022.

Awareness of Neonatal Danger Signs and Timely Healthcare-Seeking Behaviour in Mothers of 0–12-Month-Old Infants

Introduction: Neonatal mortality is a critical issue in Indonesia, with a staggering 63% of infant deaths occurring during this period. Early detection of neonatal danger signs is vital in encouraging mothers to seek healthcare services promptly. Further research is necessary to evaluate the level of knowledge among mothers regarding neonatal danger signs and their healthcare-seeking behaviour in primary healthcare facilities within Tangerang District, which has the highest neonatal mortality rate. Methods: A cross-sectional study assessed the knowledge of neonatal danger signs in mothers with infants aged 0-12 months. Data was collected through interviews and questionnaires and analyzed using SPSS-25 and the Pearson Chi-Square test (p < 0.05). Results: Two factors were significantly associated with healthcare-seeking behaviour: knowledge of neonatal danger signs (p=0.000, AOR=13.374, 95% CI) and maternal education (p=0.019, AOR=14.939, 95% CI). Conclusions: Educating mothers of infants about neonatal danger signs increases their likelihood of seeking healthcare for their babies. Health education campaigns and initiatives are crucial to promoting awareness of neonatal health among caregivers.

Paternal Knowledge about Neonatal Danger Signs and Associated Factors in Bishoftu Town, Central Ethiopia, 2022: Community-based Cross-Sectional Study

Paternal Knowledge about Neonatal Danger Signs and Associated Factors in Bishoftu Town, Central Ethiopia, 2022: Community-based Cross-Sectional Study

Knowledge of Neonatal Danger Signs among Postnatal Mothers at Women and New born Hospital - University Teaching Hospitals in Lusaka Zambia.

Purpose: The awareness and identification of neonatal danger signs by mothers play a significant role in a neonate's survival and future health. The survival of neonates is thought to be increased by providing a clear understanding of neonatal danger signs. This study aimed to assess postnatal mothers' knowledge of neonatal danger signs and associated factors. Methodology: A cross-sectional analytical study design was used to conduct a study at Women and Newborn Hospital UTH in Lusaka Zambia with a total number of 150 participants. Participants recruited in the study included all mothers aged 18 and above seeking care at UTH from day six today twenty-eight after delivery. Data was collected using the validated Neonatal Danger Signs Knowledge and Practices Questionnaire (NDSKQ) tool and SPSS version 26 was used to analyse data. A Binary logistic regression analysis was done to identify factors associated with Neonatal danger signs. Findings: Slightly above half (53%) of the respondents had poor knowledge on neonatal danger signs. Age, marital status, educational level, parity, antenatal care attendance and family support system were associated with knowledge on neonatal danger signs with all p values of less than or equal to 0.05. Younger mothers (18-20 years) (56.5%) were more likely to have poor knowledge compared to older mothers. Married mothers (68%) and those who were divorced or widowed (60%) were more likely to have better knowledge compared to single mothers, mothers with tertiary education (60%) had better knowledge compared to those with none/primary education (58%), mothers with more children (66.7%) were less likely to have poor knowledge compared to those with their first child (50%), mothers who attended antenatal care six times or more (67.1%) had better knowledge compared to those who attended five times or less (53.8%) and mothers with a family support system (75%) were more likely to have good knowledge compared to those without (53%) all the associations were statistically significant. Unique contribution to theory, policy and practice: There is need to focus on training in maternal identification of neonatal danger signs. Personalised education for mothers, considering age and education level, and integrating family involvement and cultural competence into care delivery are crucial. Nursing education should advance through specialized curricula, utilizing advanced simulation training and interdisciplinary collaboration to enhance clinical skills in identification of neonatal danger signs and promote maternal awareness of neonatal dangers signs, ultimately improving neonatal health.

Predictors of mortality among low birth weight neonates after hospital discharge in a low-resource setting: A case study in Uganda.

Most neonatal deaths occur among low birth weight infants. However, in resource-limited settings, these infants are commonly discharged early which further exposes them to mortality. Previous studies on morbidity and mortality among low birth weight infants after early discharge mainly focused on very low birth weight infants, and none described post-discharge neonatal mortality. This study aimed to determine the proportion and predictors of mortality among low birth weight neonates discharged from the Special Care Baby Unit at Mulago National Referral Hospital in Uganda. This was a prospective cohort study of 220 low birth weight neonates discharged from the Special Care Baby Unit at Mulago National Referral Hospital. These were followed up to 28 completed days of life, or death, whichever occurred first. Proportions were used to express mortality. To determine the predictors of mortality, Cox hazards regression was performed. Of the 220 enrolled participants, 216 (98.1%) completed the follow-up. The mean gestational age of study participants was 34 ±3 weeks. The median weight at discharge was 1,650g (IQR: 1,315g -1,922g) and 46.1% were small for gestational age. During follow-up, 14/216 (6.5%) of neonates died. Mortality was highest (7/34, 20.6%) among neonates with discharge weights less than 1,200g. The causes of death included presumed neonatal sepsis (10/14, 71.4%), suspected aspiration pneumonia (2/14, 14.3%), and suspected cot death (2/14, 14.3%). The median time to death after discharge was 11 days (range 3-16 days). The predictors of mortality were a discharge weight of less than 1,200g (adj HR: 23.47, p <0.001), a 5-minute Apgar score of less than 7 (adj HR: 4.25, p = 0.016), and a diagnosis of neonatal sepsis during admission (adj HR: 7.93, p = 0.009). Post-discharge mortality among low birth weight neonates at Mulago National Referral Hospital is high. A discharge weight of less than 1,200g may be considered unsafe among neonates. Caregiver education about neonatal danger signs, and measures to prevent sepsis, aspiration, and cot death should be emphasized before discharge and during follow-up visits.

The receipt of health information on neonatal dangers signs during the immediate postpartum period and its determinants in Ethiopia: a multilevel mixed-effects logistic regression analysis of the 2016 Ethiopian demographic health survey report

BackgroundIdentification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women’s awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia.MethodsThe data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables.ResultsThe receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs.ConclusionThe findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage.

Using verbal and social autopsy approaches to understand why neonates die in rural settings: a case study of a remote rural district in Uganda

IntroductionNeonatal mortality remains a formidable challenge in low-resource settings, such as Uganda, despite global health initiatives. This study employs a social and verbal autopsy approach to identify the causes, settings...

Assessment of knowledge about neonatal danger signs among primiparous women at discharge from healthcare facilities.

This study explores the evaluation of knowledge regarding neonatal danger signs (NDS) among first-time mothers in Pakistan during their discharge from healthcare facilities. The investigation aimed to establish connections between their understanding of NDS and factors such as sociodemographic background, prenatal check-ups, and educational measures. Considering the persistently high neonatal mortality rates in low- and middle-income nations, recognizing maternal NDS awareness becomes crucial for promoting early medical attention and reducing neonatal health risks. Existing research highlights the role of maternal knowledge in shaping neonatal well-being; however, gaps in knowledge remain prevalent, especially among first-time mothers. Using a cross-sectional approach, data were gathered through structured questionnaires, revealing significant relationships among maternal NDS awareness, sociodemographic aspects, prenatal care, and educational interventions. It is noteworthy that first-time mothers demonstrated lower NDS knowledge than mothers with multiple childbirth experiences, while those with higher education displayed greater awareness The effects of educational interventions were diverse, and antenatal visits were linked to enhanced knowledge. This study highlights the significance of focused treatments that target knowledge deficiencies, which can empower women and contribute to the reduction of infant health problems and mortality. encouraging further exploration of effective strategies to augment maternal knowledge and proactive healthcare-seeking behaviors.

Mothers' Knowledge of Neonatal Danger Signs: A Cross-Sectional Study

Aim: This study was performed to investigate mothers' knowledge of neonatal danger signs. &#x0D; Materials and Methods: The present research is a cross-sectional and descriptive study. The study was carried out in a children's hospital in the southeast of Turkey. The study sample consisted of 214 mothers who had infants aged between 0-12 months, did not have communication barriers, and agreed to participate in the study. Data were collected by the face-to-face interview method using the Demographic Information Questionnaire and the Neonatal Danger Signs Information Form. &#x0D; Results: The mean danger signs knowledge score of the mothers was found to be 9.78±3.41. The knowledge of 88.3% of the mothers was at a "good" level. The mothers reported cough and diarrhea as danger signs at the highest rate of 81.8%, fever at a rate of 80.4%, and vomiting and malnutrition at a rate of 79%. The factors affecting the mothers' knowledge of danger signs (high/low) were examined by binary logistic regression analysis, and it was found that income status affected their knowledge (p

Awareness and healthcare seeking behavior of neonatal danger signs, and predictor variables among mothers/caregivers in four developing regional state of Ethiopia

Introduction: Mothers/caregivers should be aware of a newborn’s danger signs and promptly seek medical attention. Hence, this study assessed mothers’/caregivers’ awareness, healthcare seeking behaviors for neonatal danger signs and their determinants in the developing regional state of Ethiopia.MethodsA community-based cross-sectional study was employed among mothers/caregivers of neonates in the developing regional state of Ethiopia. The sample was determined in collaboration with the Central Statistics Agency of Ethiopia. Stratified multi-stage cluster sampling was used to recruit the sample. Data were collected through an interviewer administered structured questionnaire using a tablet computer. Descriptive statistics and binary logistic regression were applied to identify determinants of awareness and treatment-seeking behavior for neonatal danger signs.ResultsThe result of the study showed that nearly one-third (32.7%) of the respondents had a good level of awareness of neonatal danger signs, and 69.0% of the respondents had good healthcare-seeking practice about neonatal danger signs. Regional state (Benishangul-Gumuz) [AOR = 1.61; 95% CI (1.09, 2.39)], Muslim’s [AOR = 1.75; 95% CI (1.20, 2.55)] and permission to travel to a health facility [AOR = 0.48; 95% CI (0.37, 0.63)] were determinants of mothers’/caregivers’ awareness about neonatal danger signs. Antenatal care (ANC) attendance and institutional delivery were shown to have a positive association with neonatal healthcare seeking (AOR = 2.14 and AOR = 2.37, respectively).ConclusionIn Ethiopia’s developing regional states, mothers/caregivers were remarkably unaware of neonatal danger signs. Region, religion, mothers’/caregivers’ age, and need for permission to travel to a health facility were predictor variables for neonatal danger sign awareness. Better healthcare seeking practices, which are determined by ANC attendance and institutional delivery, are observed in these regions. Federal and regional governments should give these regions due attention. Moreover, regional health bureaus and health professionals should tackle the problem by focusing on the identified factors.

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.

Identifying gaps in maternal knowledge and care-seeking for neonatal health: A mixed methods study in rural pregnant women.

Knowledge of neonatal danger signs is crucial for timely care-seeking and improved newborn survival. This study assessed this knowledge among pregnant women in rural western Gujarat. A mixed methods study was conducted among 390 pregnant women selected through a two-stage sampling procedure. Quantitative data were collected using a structured questionnaire. Qualitative data were gathered via in-depth interviews with 20 purposively sampled women. Logistic regression identified determinants of knowledge. Thematic analysis was done for qualitative data. The majority of women were young (220, 56.5% ≤25 years), literate (333, 85%), and from rural backgrounds (320, 82%). Overall, 232 (59.5%) knew about cord care, and 301 (77.2%) correctly identified breastfeeding initiation time. Recognition of key danger signs such as fever (311, 79.7%), vomiting (292, 74.8%), and jaundice (275, 70.5%) was high, but only 70 (18%) identified chest in-drawing. Multiparity (adjusted odds ratio (AOR): 1.4, 95% confidence interval (95% CI): 1.2-3.9), lower age (AOR: 3.8, 95% CI: 2.4-5.8), education (AOR: 3.1, 95% CI: 1.5-6.4), inadequate counseling (AOR: 2.2, 95% CI: 1.82-5.190), and normative delivery (AOR: 2.4, 95% CI: 1.16-5.006) were associated with poor knowledge. Qualitative findings revealed reliance on informal sources, family elders, and financial constraints as key barriers along with limited comprehension of some danger signs. Focused interventions via health workers, family members, and community platforms are needed to increase neonatal danger signs awareness among vulnerable women in the region to enable timely care-seeking.

Nursing Students' Knowledge and Attitudes toward Danger Signs in Neonatal Illnesses.

Background and Objectives: Neonates can show subtle signs of illness that could be overlooked by their mothers and caregivers. Therefore, basic knowledge regarding neonatal health and early detection of neonatal diseases can help improve survival. We assessed nursing students' knowledge and attitudes toward the danger signs of neonatal illnesses. Materials and Methods: We performed a descriptive cross-sectional study using a structured online questionnaire based on danger signs categorized by the World Health Organization to assess knowledge of neonatal illness danger signs among nursing students. Results: We assessed 342 students, of which 67.0% (95% CI: 61.8-71.7) had good knowledge regarding neonatal illness danger signs, and 71.6% received information about neonatal care. About 33% of the participants had a basic knowledge of neonatal care, such as breastfeeding, immunization, routine postnatal care, and eye care. Students who received information on neonatal care were three times (AOR = 2.95, 95% CI: 11.59-5.47, p = 0.001) more likely to have good knowledge than those who did not. The students also showed a positive attitude towards the importance of knowledge regarding neonatal illness danger signs, teaching this subject in their college, participating in studies involving the practice and knowledge of mothers regarding neonatal illness danger signs, and the importance of knowledge in reducing neonatal mortality in the region. Conclusions: More training programs on neonatal care should be implemented to enhance knowledge and raise nursing students' awareness of the dangerous signs of neonatal illnesses.

Health Care Seeking Behavior Towards Neonatal Danger Signs and Associated Factors Among Mothers in Kamba Zuria District, South Ethiopia

Health Care Seeking Behavior Towards Neonatal Danger Signs and Associated Factors Among Mothers in Kamba Zuria District, South Ethiopia

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&lt;0.001). Antenatal care counselling was strongly associated with knowledge of newborn danger signs (adjusted odds ratio=1.57, P&lt;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.

Mothers' health care seeking behavior for neonatal danger sign in southern Ethiopia: Community based cross-sectional study.

Over the previous few decades, significant progress has been made in reducing newborn mortality, but the worldwide scale of the problem remains high. A considerable number of newborn death and difficulties owing to neonatal danger signs could be avoided if mothers sought appropriate health care for common neonatal risk indications, according to a number of studies presently underway in Ethiopia. The aim of this study is to assess health care seeking behavior of mothers' in related to neonatal danger signs. A community-based cross-sectional study was conducted among 410 participants in Wolaita Sodo, From October 1 to October 30, 2019. To collect data, structured interviewer administered questionnaire was used. Data was coded, cleaned, recoded and entered in to epi-data version 3.1 and transported to SPSS window version 21 for analysis. Multivariable logistic regression was carried out and p-value of less than or equal to 0.05 was considered statistically significant. A total of 410 mothers participated in this study, 110 (47.6%) mothers preferred health intuition for their neonate. Husband educational status (AOR = 2.4, 95% CI = 1.1, 5.5), communication media (AOR = 4.3, 95% CI = 2.4, 7.5), place of residence (AOR = 3.5, 95% C.I = 1.9, 6.7), ANC follow up (AOR = 2.8, 95% CI = 1.4, 5.8), and PNC follow (AOR = 1.7, 95% CI = 1.1, 3.1) were all factors that significantly associated with health care seeking practice neonatal dander signs. Overall, there was a low degree of health-seeking practice. The educational status of the mother's husband, communication media, residence, ANC follow-up, and PNC follow-up all predicted the mothers' health-care seeking behavior. The study also identifies the Wolaita Zone and Sodo town health offices, the health development army, one to five local community organizations with and health extension workers as key contributors.

The prevalent practice and attitude toward neonatal danger signs among mothers in Eastern Province, Saudi Arabia

The prevalent practice and attitude toward neonatal danger signs among mothers in Eastern Province, Saudi Arabia

Influence of Husband Involvement during Antenatal Clinic on Knowledge of Neonatal Danger Signs among Mothers Attending Well Baby Clinics in Nakuru County-Kenya: A Quasi Experimental Study

Introduction: Male involvement is associated with improved maternal and newborn outcomes as they play a vital role in decision making in health seeking.&#x0D; Objective: To determine the influence of husbands’ accompaniment to the antenatal clinic on maternal knowledge of neonatal danger signs (NDS) after nurses’ capacity building.&#x0D; Study design: A quasi experimental study.&#x0D; Method: Eight health facilities were selected at random among facilities in Nakuru County. Mothers attending well baby clinics with children &lt;1 year were interviewed using structured questionnaires. Analysis was done using the SPSS software (version 23).&#x0D; Results: Two different cohorts of 414 mothers each were interviewed at baseline and at the end with 176 (42.5%) and 200 (48.3%) of mothers respectively being accompanied by husbands for antenatal clinic. At baseline they were likely to identify inability to breastfeed, convulsions and hypothermia as NDS and these were statistically significant with p &lt;0.004, P&lt; 0.003 and P&lt; 0.033 respectively. Identification of more 3 NDS increased from 37 (21%) at baseline to 99 (49.5%) with all mentioning at least one NDS at the end point.&#x0D; Conclusion: Male partner accompaniment to antenatal care was found to have a positive correlation to maternal knowledge of NDS with nurses’ capacity building playing a big role.