Essential Newborn Care Practices Research Articles

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. 
 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. 
 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. 
 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.

A Cross sectional Study on Nurses Knowledge and Practice of Essential Newborn Care at Tertiary Care Hospitals of Bahawalpur

The newborn survival, growth, and development depend on the knowledge of essential infant care and correct application. The World Health Organization's guideline is crucial, yet the majority of healthcare professionals are unaware of it and do not adhere to it. Four million infants die every year, primarily in developing countries. For every 1,000 live births in Pakistan, there are 40.4 neonatal fatalities. Objectives: To examine nurses understanding and their application of newborn care at Bahawalpur tertiary care hospitals. Methods: At Bahawalpur's tertiary care hospitals, a cross-sectional study was done. Using a random sampling procedure, 280 registered nurses who provide labor and delivery and neonatal care were chosen. Participants were given self-administered questionnaires in order to gather data. Input and analysis of the data were done with SPSS Version 21.0. Frequency and percentages were used to present qualitative characteristics. A P value of 0.05 was employed to evaluate statistical significance. Results: Study participants averaged a 24.28 on a knowledge scale. 53.2 % of respondents had strong knowledge, while 47.8 % had low knowledge, according to the research. 52.1 % of respondents had an excellent level of practice, while 48.9 % had a low level, according to the mean practice score of 33.83. Conclusions: On some crucial aspects of neonatal care, the research population had inadequate knowledge and experience. Therefore, while assigning employees to the delivery room, preference should be given to participants with higher knowledge. Those who perform well should also be commended

Evaluation of interventions for essential newborn care practices at home-based delivery in India

Abstract India has the largest share of neonatal mortality, accounting for 21.7 per 1,000 in 2019, while the global goal is at least 12 per 1,000 by 2030. More than 20% of deliveries still occur at home in India for various reasons. Several national interventions were designed to ensure essential practices even at home by engaging skilled birth attendants (SBAs), antenatal care (ANC), and community health workers (CHWs). This study evaluates the effectiveness of these interventions on essential newborn care practices (EP); clean cord care, thermal care, and breastfeeding. Using data from the 2015-2016 India Demographic and Health Survey (n = 9,273), this study employs structural equation modeling to confirm the relationship between SBA, ANC, CHWs` counseling, and EP, including indirect effects of ANC and CHWs and moderating effects of women's empowerment. The results show that SBA and ANC have significant direct effects (standardised coefficient=0.105 and 0.056, respectively) on EP, and ANC and CHWs have significant indirect effects (0.015 and 0.004) in the well-fitted model (CFI=0.938, TLI=0.920, RMSEA (upper 90% CI)=0.028 (0.029), SRMR=0.044). The empowerment-related factors which had a significant positive moderating effect on the paths from SBA to EP and from ANC to EP are decision-making power (0.007, 0.003), allowed mobility (0.002, 0.001), and education (0.009, 0.004). More than 90% of EP variance is not associated with the factors in this model (standardised coefficient=0.958). SBA demonstrated the most considerable effectiveness for EP, while ANCs and CHW indirectly impacted EP. Improving women's empowerment can be an effective strategy to enhance EP. Previous literature said that the other factors explaining EP could be quality of care, other interventions for a safe birth, and cultural characteristics. Policymakers are recommended to consider comprehensive factors to address barriers to safe home birth and design CHW's intervention to persuade SBA. Key messages

Predictors of knowledge and practice of newborn care among post-natal mothers attending immunisation clinics in Southeast Nigeria.

Evidence-based newborn care practice recommended by WHO reduces neonatal mortality and improves neonatal outcomes. This study assessed the knowledge, practice-associated factors and predictors of essential newborn care among post-natal mothers in two primary health care centres in Southeast Nigeria. A cross-sectional total population study. Two primary health care centres in two local government areas in Southeast Nigeria. Post-natal mothers who attended immunisation clinics. Quantitative data was collected over four weeks from 400 post-natal mothers. Chi-square test and logistic regression were carried out for associations and predictors, respectively. Analytical decisions were taken at p<0.05 and 95% confidence interval. Knowledge, attitude, the practice of essential newborn care; predictors of practice. Mean age of participants was 28.68±5.4. The majority (78.9%) had been counselled on newborn care and 85.2% delivered in a formal health facility. The majority (77%) had good knowledge of essential newborn care and practices (61%). More than half (62.3%) reported support from health workers. Predictors of good practice were older age (AOR: 0.435; 95%CI: 0.212-0.893), being married (AOR: 8.095; 95%CI: 3.732-17.558), living in the urban area (AOR: 0.478; 0.291-0.784), and having good knowledge of newborn care (AOR: 0.239; CI: 0.139-0.411). Good practice was identified in the majority. Being married, older, living in urban areas and having good knowledge were predictors of good practice. Health facility delivery, continuous support by health workers and post-natal education to mothers in rural areas are recommended policy priorities. None declared.

Skilled maternal healthcare and good essential newborn care practice in rural Bangladesh: A cross-sectional study.

Background and AimsEssential newborn care (ENC) practices play an important role in reducing the risk of infant mortality and morbidity. Therefore, more studies are needed on ENC practices. Skilled maternal healthcare can be a good strategy to increase the practice. Learn about the independent and joint effects of skilled maternal healthcare during pregnancy and childbirth on newborn care practices.MethodsThe study used a cross‐sectional data obtained from Bangladesh Multiple Indicator Cluster Survey, 2019. To investigate the association between maternal healthcare utilization and good ENC practice (cord care, delayed bathing, and immediate breast‐feeding), χ 2 test and t‐test in bivariate and binary logistic regression analysis, respectively have been performed after taking into account complex survey design.ResultsOnly about 24% (95% confidence interval [CI]: 22.95%–25.89%) women given birth at home in rural Bangladesh followed good newborn care practice. The results obtained from adjusted regression analysis showed that a woman was 24%, 49%, and 75% more likely of having good ENC practice if she received four or more skilled checkups during antenatal period only (adjusted odds ratios [AOR]: 1.24, 95% CI: 0.97, 1.60), received assistance from SBA during delivery only (AOR: 1.49, 95% CI 1.12, 1.97) and received skilled healthcare in both pregnancy and delivery (AOR: 1.75, 95% CI 1.13, 2.71), respectively compared to a woman who did not get an opportunity to receive skilled healthcare during pregnancy and delivery. Among the selected confounders, maternal age at birth, birth order, education of household heads and religion showed a significant association with good ENC practice.ConclusionThe study revealed that proper maternal healthcare during pregnancy and childbirth from skilled health personnel can improve the rate of ENC practices. For this, more training programs should be started, especially at the community level, and health promotion activities are needed to create awareness about efficient maternal healthcare practices.

Essential newborn care practices in Zambia.

Neonatal mortality remains high in Zambia and is declining slower than infant and under five mortality. Improved adoption of essential newborn care (ENC) could help mitigate this situation. To determine the adoption of ENC practices in Zambia, cross-sectional data was used to assess ENC practices including baby kept warm, umbilical cord care and breastfeeding. Chi-square was used to assess whether maternal and social demographic factors were related to ENC. Households surveyed were 12,507, which included 5,741 women with children under two years. Findings show that 95.4% of babies were dried immediately after birth, 96.5% wrapped in a cloth/blanket, 76.7% put on mother’s torso and 68.5% head covered (51.6% for all four). Eightyfive- point six percent of baby’s cords were cut with a sharp and clean instrument, 46% cord kept dry and 42.1% cord kept clean (31.2% for all three). Ninety-six-point nine percent of babies were breastfed, 89.3% were initiated within one hour and 93% exclusively breastfed for the first 3 days post-delivery (82% for all three). Babies kept warm were associated with skilled birth attendance (SBA) and province, umbilical cord care with SBA, >4 antenatal care (ANC) visits, marital status and province, and breastfeeding with >4 ANC visits, marital status and province. Early and exclusive breastfeeding is widely practiced. However, appropriate thermal and cord care practices are low. There is need for a scale-up of appropriate newborn care practices in Zambia and SBA could play an important role in this regard.

Assessing essential new born care practice and associated factors in mothers who gave birth within the last 6 months in east badewacho woreda, hadiyya zone, Ethiopia

Background: Every year, more than 2.7 million new-borns die before reaching neonatal age in the world, with the majority of these deaths occurring at home. Surprisingly, half of these occur within the first 24 hours of delivery, and 75% occur in the early neonatal period. One low-cost approach to improving new-born baby health outcomes is to promote essential new-born care practices. Objective: Thus, the purpose of this study was to evaluate essential new-born care practices and associated factors among mothers who gave birth within the last 6 months in East Badewacho woreda, Hadiyya zone. Methods: From March 1 to April 30, 2018, a community-based cross-sectional study was designed. The sampled population consisted of 399 mothers who had live births within the previous six months, as determined by a multistage random sampling technique. The data was collected using a semi-structured questionnaire and entered into Epi-data version 3.1 before being exported to SPSS version 21 for analysis. A binary logistic regression analysis with a 95% confidence interval was performed. Results: Less than half of the mothers (34.1 %) practice essential new-born care. The husband's educational status [AOR=0.24, CI (0.089, 0.64)] and [AOR=0.314, CI (0.126, 0.78)], place of delivery [AOR=0.024, CI (0.009, 0.068)] and knowledge of essential new-born care [AOR=2.03, CI (1.223,3.371)] were significant predictors of essential new-born care practice. Conclusion: The study's findings revealed that essential new-born care was not widely practiced in East Badewacho Woreda. As a result, strengthen the link between health centers and health posts in order to increase ANC, institutional delivery, and PNC service utilization.

Knowledge, Practice, and Associated Factors of Essential Newborn Care among Sudanese Women in Eastern Sudan.

(1) Background: There is a high neonatal mortality rate in countries with low resources, especially sub-Saharan countries. There is no published data in Sudan on mothers’ knowledge and practice of essential newborn care. This study aimed to assess the maternal knowledge and practice of essential newborn care in Gadarif city, eastern Sudan. (2) Methods: A cross-sectional study was conducted in Gadarif city, eastern Sudan. Postnatal mothers (384) were recruited from postnatal and vaccination clinics. A structured questionnaire was used to collect the data. Mothers who responded to essential newborn care knowledge and practice items at a rate equal to 75% or above were classified as having good knowledge and practice. Logistic regression analysis was performed to identify the factors associated with essential newborn care knowledge and practice. (3) Results: In this study, 268 (66.4%) and 245 (63.8%) of the 384 participants had good knowledge and practice of essential newborn care, respectively. None of the investigated factors (age, residence, education, occupation, parity, antenatal care, and mode of delivery) was associated with knowledge and practice of essential newborn care with sociodemographic and obstetric factors. Mothers with poor knowledge were less likely to have good practices (adjusted odds ratios = 0.41; 95% CI (0.26–0.64)). The reported malpractices were giving dietary supplements to the babies (48.2%), mainly water (40.0%) and cow’s milk (43.2%), and putting substances on the umbilical cord (62.8%), with butter (92.1%) accounting for the majority. (4) Conclusion: In the present study, around two-thirds of the participants had good essential newborn care knowledge and practice. Poor knowledge was less likely to be associated with good newborn care practices. More research is needed to build baseline data for neonatal mortality reduction plans.

Essential newborn care practices for healthy newborns at a district hospital in Pemba, Tanzania: a cross-sectional observational study utilizing video recordings

ABSTRACT Background High-quality essential newborn care (ENC) can improve newborn health and reduce preventable newborn mortality. The World Health Organization recommends specific ENC interventions. Video recordings have potential as a tool for assessment of clinical care also in low and middle-income countries. Objective To use video observations of healthy newborns to describe ENC practices in a low-income setting and compare actual clinical practice with WHO recommendations. Method This is a cross-sectional observational study. Video records of neonatal interventions to 324 healthy newborns were assessed. They were obtained at baseline of a pre-post intervention study during a 10-week study period in Pemba, Tanzania. Data also included postnatal structured questionnaires. Eight ENC interventions and quality indicators were defined as per the WHO recommendations. Descriptive statistics were used to summarize ENC practices and maternal and neonatal characteristics. Results None of the newborns received all eight recommended ENC interventions. The median duration of separation from the mother was 25 minutes and 15 seconds (ranging from 22 seconds to 3 hours and 36 minutes), 51% of the newborns received proper thermal care during the separation. Twenty-one percent had sufficient umbilical cord care, 8% were stimulated for breathing, 69% were observed at least once by healthcare staff and 9% did undergo suctioning. None of the newborns received antibiotic ointments or vitamin K. Conclusion Video recording of healthy newborns was feasible. The study identified omission of key ENC practices including proper thermal care, skin-to-skin contact and establishment of breastfeeding within the first hour of life, vitamin K administration as well as application of unnecessary practices such as excessive suctioning of breathing newborns.

Quality newborn care in East New Britain, Papua New Guinea: measuring early newborn care practices and identifying opportunities for improvement

BackgroundRenewed attention and investment is needed to improve the quality of care during the early newborn period to address preventable newborn deaths and stillbirths in Papua New Guinea (PNG). We aimed to assess early newborn care practices and identify opportunities for improvement in one province (East New Britain) in PNG.MethodsA mixed-methods study was undertaken in five rural health facilities in the province using a combination of facility audits, labour observations and qualitative interviews with women and maternity providers. Data collection took place between September 2019 and February 2020. Quantitative data were analysed descriptively, whilst qualitative data were analysed using content analysis. Data were triangulated by data source.ResultsFive facility audits, 30 labour observations (in four of the facilities), and interviews with 13 women and eight health providers were conducted to examine early newborn care practices. We found a perinatal mortality rate of 32.2 perinatal deaths per 1000 total births and several barriers to quality newborn care, including an insufficient workforce, critical infrastructure and utility constraints, and limited availability of essential newborn medicines and equipment. Most newborns received at least one essential newborn care practice in the first hour of life, such as immediate and thorough drying (97%).ConclusionsWe observed high rates of essential newborn care practices including immediate skin-to-skin and delayed cord clamping. We also identified multiple barriers to improving the quality of newborn care in East New Britain, PNG. These findings can inform the development of effective interventions to improve the quality of newborn care. Further, this study demonstrates that multi-faceted programs that include increased investment in the health workforce, education and training, and availability of essential equipment, medicines, and supplies are required to improve newborn outcomes.

Effect of health facility linkage with community using postnatal card on postnatal home visit coverage and newborn care practices in rural Ethiopia: A controlled quasi-experimental study design.

BackgroundPostnatal home visit has the potential to improve maternal and newborn health, but it remains as a missed opportunity in many low-and middle-income countries. This study examines the effect of health extension worker administered postnatal card combined with health facility strengthening intervention on postnatal home visit coverage, newborn care practices, and knowledge of newborn danger signs in rural Ethiopia.MethodsWe employed quasi-experimental design using controlled before-and-after study in intervention and comparison districts of rural Tigray, northern Ethiopia. Training of health extension workers (HEWs) on postnatal home visit (PNHV), training of healthcare providers on maternal and newborn care, and capacity building of healthcare authorities on leadership, management and governance together with health system strengthening were the implemented interventions. Baseline (n = 705) and end line (n = 980) data were collected from mothers who delivered a year before the commencement of the actual data collection in the respective surveys. We used difference-in-differences (DiD) analysis to assess the effect of the intervention on PNHV coverage, essential newborn care practices and maternal knowledge of newborn danger signs.ResultsA total of 1685 (100%) mothers participated in this study. In all districts, more than 1/3rd of the mothers 633(37.57%) were in the age of 30–39 years. The difference-in-differences estimator showed an average of 23.5% increase in coverage of PNHVs within three days (DiD, p<0.001) and the provision of most postnatal contents significantly increased in the intervention district in the end line survey. The knowledge of at least three danger signs increased by 13.6% (p = 0.012).The DiD estimator showed an average of 27.6% increase to check the mothers for heavy bleeding (DiD, p = 0.011). This study also revealed that the checking of maternal blood pressure increased from 5.8% to 11.8% in the comparison districts and from 9.4% to 93.3% in the intervention district. The difference-in-differences estimator result showed a 9% difference in clean cord care practices among the participants (p = 0.025), 12.2% in skin to skin care (p = 0.022), and borderline significant increase in early initiation of breastfeeding (10.5%, p = 0.051).ConclusionWe conclude that the intervention package was effective in improving the coverage of PNHV, increase in knowledge of newborn danger sign and essential newborn care practices. Hence, further strengthening the linkages between health facilities and community is imperative to improve the coverage of essential lifesaving maternal and newborn care services by HEWs at home.

Can Flip-Chart Assisted Maternal Education Improve Essential New Born Care Knowledge and Skills? A Randomized Controlled Trial

BackgroundDespite the implementation of essential newborn care (ENC) by the World Health Organization, knowledge gaps among postpartum women persist. Inappropriate breastfeeding practices and lack of knowledge regarding ENC among mothers has resulted in higher neonatal mortality.PurposeOur study focused on evaluating the effectiveness of flip-chart assisted postpartum maternal education in improving ENC knowledge and skills.Material and MethodsA single blind parallel randomized controlled trial was carried out with 120 primigravidae. Participants were allocated to the intervention group (IG) or the control group (CG) by block randomization. A pretested validated questionnaire was administered to participants in both groups within 24 h post-delivery. Women in the IG were provided flip-chart assisted education regarding ENC approximately 24 h post-delivery. Women in both groups received verbal advice on ENC from the postnatal ward nurses, as per the existing hospital policy. ENC skills were observed in all participants in postnatal wards by independent observers. 6 months later, knowledge retention was assessed and analyzed in both groups.ResultsAntenatal education remained at 32% among all postnatal women. Postnatal flip-chart-assisted maternal education had a significant impact on ENC skills in the IG (p < 0.01) and precipitated higher knowledge scores at the end of 6 months (p < 0.01) in the IG.Conclusion for PracticeFlip-chart assisted education soon after delivery had a sustained effect on ENC knowledge and practices that persisted for 6 months post-delivery.

Community-based new born care practice and its associated factors among women who give birth at home in Ethiopia: cross-sectional study

Background In Ethiopia, perinatal mortality rate was 33 per 1000 pregnancies and 64.4% of this death was occurred within the first 7 days of neonatal life. Moreover, more than 2.1% of new born babies were died within their first seven days of life in Ethiopia. Majority of neonatal deaths are preventable by applying an effective and lifesaving interventions. However, little is known about newborn care practice at the community level. Methods A community-based cross-sectional study design was used. Multi-stage sampling techniques were used to get a total of 540 mothers who gave birth at home within the past six months from their kebeles in Ethiopia. Data was collected by using face-to-face interview with structured questionnaires. Then the data was coded, cleaned, and entered into Epidemiological data version 3.1 and exported to statistical package for social science version 23.0 for analyses. Bivariate and multivariable logistic regression model was used to identify statistically significant associations between dependent and independent variables. The odds ratio at 95% confidence interval with P-Value 0.05% was computed. Results A total of 540 women were participated with a response rate of 98.3%. Only 208 (44%) of the women had good practice towards essential newborn care. Head of households [AOR (95%CI) 2.7417 (1.80–4.25)], type of birth attendant [AOR (95%CI) 3.962 (3.329–7.171)] and bad obstetrical history [AOR (95%CI) 3.151 (2.209–4.969)] were significantly associated with maternal newborn care practice. Conclusion Less than half of the mothers had good newborn care practice. In this study, head of household, type of birth attendant, and bad obstetrical history were significantly associated with maternal newborn care practice. Therefore, Ministry of Women and Woreda women and Child offices needs to promote the socioeconomic empowerment of women to increase the practice of essential newborn care practices.

Facility level factors that determine consistent delivery of essential newborn care at health centers in Ethiopia

BackgroundEssential newborn care (ENC) is a package of interventions which should be provided for every newborn baby regardless of body size or place of delivery immediately after birth and should be continued for at least the seven days that follows. Even though Ethiopia has endorsed the implementation of ENC, as other many counties, it has been challenged. This study was conducted to measure the level of essential newborn care practice and identify health facility level attributes for consistent delivery of ENC services by health care providers.MethodsThis study employed a retrospective cross-sectional study design in 425 facilities. Descriptive statistics were formulated and presented in tables. Binary logistic regression was employed to assess the statistical association between the outcome variable and the independent variables. All variables with p < 0.2 in the bivariate analysis were identified as candidate variables. Then, multiple logistic regression analysis was performed using candidate variables to determine statistically significant predictors of the consistent delivery of ENC by adjusting for possible confounders.ResultsA total of 273, (64.2%), of facilities demonstrated consistent delivery of ENC. Five factors—availability of essential obstetrics drugs in delivery rooms, high community score card (CSC) performances, availability of maternity waiting homes, consistent partograph use, and availability of women-friendly delivery services were included in the model. The strongest predictor of consistent delivery of essential newborn care (CD-ENC) was consistent partograph use, recording an odds ratio of 2.66 (AOR = 2.66, 95%CI: 1.71, 4.13). Similarly, providing women-friendly services was strongly associated with increased likelihood of exhibiting CD-ENC. Furthermore, facilities with essential obstetric drugs had 1.88 (AOR = 1.88, 95%CI: 1.15, 3.08) times higher odds of exhibiting consistent delivery of ENC.ConclusionThe delivery of essential newborn care depends on both health provider and facility manager actions and availability of platforms to streamline relationships between the clients and health facility management.

Assessment of Factors Associated with Practice and Knowledge of Essential Newborn Care Among Nurses and Midwives, Western Ethiopia, 2021.

Background: Promoting basic newborn care skill and practice is a cost-effective approach to improving newborn health outcomes. Objective: Intended to assess factors associated with Practice of Essential newborn care in western Ethiopia, 2021. Methods: Institutional based cross-sectional study design was conducted. Data was collected by interviewer administered structured questionnaires, entered by Epi-data 3.1version and analyzed by using SPSS version 26. The strength of association between independent and dependent variables was measured by odd ratios with 95% CI at p-value of &lt; 0.05. Conclusion: The Mean value of good score of essential newborn care practice was 41.5% with [95% CI (38.3, 48.5)]. Training, educational qualification, availability of newborn care materials and work experience were significantly associated with knowledge and practice of essential newborn care. Since practice of essential newborn care was low compared to other studies in Ethiopia identified interventional area should be focused by the stake holders.

Level of knowledge toward essential newborn care practices among postnatal mothers in governmental hospitals of Harar Town, Eastern Ethiopia.

Objectives:Essential newborn care is a set of comprehensive recommendations designed by the World Health Organization to improve the newborn’s health through intervention before conception, during pregnancy, soon after birth, and the postnatal period. Globally 4 million newborns die every year before they reach the age of 1 month. Therefore, this study assessed the level of knowledge and associated factors toward essential newborn care practices among postnatal mothers attending postnatal service in governmental hospital of Harar town, Eastern Ethiopia, 2020Methods:Facility-based cross-sectional study was conducted in Harar Town, Jugul, and HiwotFana Specialized University Hospital. Voluntary postnatal mothers who are randomly selected were participated in the study. A total number of 266 women were included in the study. Data were collected through face-to-face interviews. The training was given for data collectors, and data evaluation was done on daily basis. Cleaned data were entered to SPSS version 20, and multiple logistic regression analysis was used for better prediction of determinants and to reduce bias due to confounders. Those variables with a p value less than 0.25 were entered into multiple logistic regression analyses. Associations with p value less than 0.05 were declared as statistically significant. Text, figures, and tables presented the result.Result:The overall prevalence of good knowledge was 57.2%. Educational status, average monthly income, antenatal care visit, and parity had significantly associated with outcome variables.Conclusion:More than half of mothers had inadequate newborn care knowledge. In addition, educational status, average family monthly income, frequency of antenatal care visit, and parity were independently associated with knowledge on essential newborn care. Therefore, more significant improvement in essential newborn care practices could be attained through policy implications and recommendations. Therefore, we recommend that stakeholders of the health sector have a close follow-up on maternal and newborn care services and maintain a strategy that will incorporate maternal education service on essential newborn care practice.