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Factors associated with newborn care knowledge and practices in the upper Himalayas.

ABSTRACT: BACKGROUND:Globally, neonatal deaths remain a major public health challenge and account for the majority of deaths occurring among children under five years of age. Despite Nepal's significant achievements in meeting the maternal and child health targets of the Millennium Development Goals, an estimated 23,000 Nepalese children under five years die every year, with three out of five babies dying within the first 28 days of life. This study therefore aimed to examine the level of knowledge and practices of newborn care among Nepalese mothers in the upper Himalayas and the factors associated with these. MATERIALS AND METHODS:A community based cross-sectional study was conducted among 302 randomly selected mothers with children under two years of age in Tripurasundari Municipality of Dolpa district, an upper Himalayan region of Nepal. Mothers were interviewed using semi-structured questionnaires. Mean score for knowledge and Bloom's criteria for practice were considered to categorize newborn care knowledge and practices. Multivariate logistic regression was used to identify factors associated with the newborn care knowledge and practices. RESULTS:In this study, 147 (48.7%) of the mothers were found to have inadequate knowledge of newborn care, while 102 (33.8%) mothers had reported unsatisfactory newborn care practices. Mothers with at least secondary level of formal education were more likely to possess adequate newborn care knowledge compared to mothers who never attended school (AOR 4.93 at 95% CI 1.82-13.33). Mothers whose first pregnancy occurred between the ages of 20-24 years (AOR 3.89 at 95% CI 1.81-8.37) were also more likely to possess adequate newborn care knowledge, compared to mothers with a younger age at first pregnancy. Furthermore, mothers who had completed at least four ANC visits (AOR 2.89 at 95% CI 1.04-7.96), mothers who had completed three PNC visits (AOR 2.79 at 95% CI 1.16-6.72) and mothers who reported that their nearest health facility was less than one hour (30-59 minutes) walking distance (AOR 3.66 at 95% CI 1.43-9.33) had higher odds of having adequate newborn care knowledge. Similarly, mothers whose household monthly income was more than $100 (AOR 4.17 at 95% CI 1.75-9.69), mothers who had completed three PNC visits (AOR 3.27 at 95% CI 1.16-9.20) and mothers with adequate newborn care knowledge (AOR 15.35 at 95% CI 5.82-40.47) were found to be more likely to practice a satisfactory level of newborn care practices in adjusted analysis. CONCLUSION:The study revealed high prevalence of inadequate newborn care and knowledge amongst mothers in upper Himalayan dwellings. Approximately one third of all interviewed mothers practiced suboptimal newborn care. The results indicate an urgent need to increase awareness of neonatal services available to mothers and to prioritize investments by local governments in neonatal health services, in order to improve accessibility and quality of care for mothers and newborns.

SUBMITTER: Singh DR

PROVIDER: S-EPMC6746396 | biostudies-other | 2019

REPOSITORIES: biostudies-other

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Factors associated with newborn care knowledge and practices in the upper Himalayas.

Singh Devendra Raj DR Harvey Chloe M CM Bohara Pushpalata P Nath Dhirendra D Singh Sunita S Szabo Sylvia S Karki Kshitij K

PloS one 20190916 9

<h4>Background</h4>Globally, neonatal deaths remain a major public health challenge and account for the majority of deaths occurring among children under five years of age. Despite Nepal's significant achievements in meeting the maternal and child health targets of the Millennium Development Goals, an estimated 23,000 Nepalese children under five years die every year, with three out of five babies dying within the first 28 days of life. This study therefore aimed to examine the level of knowledg ...[more]

PMID: 31525242

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Project description:BackgroundGlobally 3.1 million children die each year in their neonatal period (first 28 days of life) according to World Health Organization (WHO) 2011 report. Half of these surprisingly occur within the first 24 h of delivery and 75% occur in the early neonatal period.MethodsA community based cross-sectional study design was carried out from March 2016 to April, 2016 in Damot Pulasa district, Wolaita zone, Southern Ethiopia to assess selected essential newborn care practices and associated factors among home delivered mothers in Damot pulasa district. Data were entered into Epi Info version 3.5.1 and exported to SPSS version 20 software for analysis. Multiple logistic analyses were done to control possible confounding variable. A P-value less than 0.05 was taken as a significant association.ResultThe study showed that the prevalence of essential newborn care practice was 24%. Multivariate logistic regression analysis revealed that variables like ANC visit (AOR =0.213,P = 0.015,CI = 0.102-0.446),PNC visit (AOR = 0.209, P = 0.00,CI = 0.110-0.399), advice about essential newborn care practice (AOR =0.114,P = 0.0001, CI = 0.058-0.221),urban areas women (AOR =2,P = 0.042, CI = 1.024-3.693), planned pregnancy (AOR = 7, P = 0.00, CI =3.732-11.813), and knowledge about newborn danger signs (AOR = 0.277, P = 0.006, CI = 0.110-0.697) were the independent predictors of ENBC practices.ConclusionGenerally, coverage of essential newborn care practices was low. ANC visit, advice about ENBC, PNC visit, residence, planned pregnancy and knowledge about newborn danger signs were predictors of essential newborn care practice in the study area. Therefore, Health facilities should enhance linkage with health posts to increase ANC and PNC service utilization. Health extension workers should also promote and give health education about pre-lacteal feeding, early bathing, planned pregnancy, newborn danger signs and application of materials on the newborn stump.

Project description:Majority of neonatal deaths in developing countries have been associated with inappropriate or poorly practiced newborn care, specifically safe cord care, optimal thermal care and early initiation and practice of exclusive breastfeeding. There is limited information about the quality of these essential newborn care practices in Accra, Ghana. The main objective of this study was to assess the knowledge about and quality of essential newborn care practices (ENC) and determine related factors in La Dade Kotopon Municipal Assembly, Accra, Ghana. A questionnaire-based, cross-sectional study was conducted among 423 mothers and caregivers in two hospitals to assess safe cord care, optimal thermal care and exclusive breastfeeding. Knowledge was assessed using eight statements regarding ENC and categorized as 'Adequate knowledge' and 'Inadequate knowledge' using a composite score. Practices were similarly categorized as 'Good' and 'Poor' ENC. Data were exported from Microsoft Excel into STATA version 15 for statistical analysis. Descriptive statistics were generated and inferential analysis was done using chi-square test and logistic regression to determine factors associated with good ENC at 95% confidence level. All respondents sampled participated in the study. A total of 263 (62%) respondents had adequate knowledge and 308 (73%) respondents practiced appropriate newborn care ('Good' ENC). The likelihood of appropriate newborn care practices was lower among mothers/caregivers who were unemployed (AOR = 0.13, 95% CI: 0.09-0.26), who had a home delivery (AOR = 0.17, 95% CI: 0.11-0.69) and made their first antenatal visit in the third trimester (AOR = 0.02, 95% CI: 0.01-0.35) compared to their counterparts. Knowledge of ENC was not associated with practice in this study. Appropriate newborn care practices were relatively high among the respondents. Improving sources of livelihood and targeted education to encourage early antenatal visits and facility-based births might improve newborn care where it is inadequate.

Project description:IntroductionHearing loss is the most common congenital condition screened for at birth in the United States, and more than 95% of newborns are currently screened for hearing. Newborn hearing screening is most effective when infants receive timely and effective interventions. Unfortunately, follow-up rates for newborns not passing their initial hearing screenings are as low as 50% in some states. Midwives are well-positioned to encourage families to follow-up with their neonatal providers when newborns are referred for further testing. Newborn hearing screening is a relatively new practice in the United States and, to date, there has been no research regarding the informational needs and practices of certified nurse-midwives or certified midwives related to hearing screening. This study examined the knowledge, attitudes, and follow-up practices of midwives related to newborn hearing screening and intervention.MethodsA survey instrument was developed and sent to 5255 American College of Nurse-Midwives members in 50 states and 2 territories.ResultsFive hundred and eighteen surveys were returned, yielding a response rate of 9.9%. Only 68% of respondents said it was very important to screen all newborns for hearing loss. Respondents reported significant gaps in their knowledge about screening procedures, steps for referral, and the availability of resources when newborns did not pass the test. Midwives also reported the need for information about hearing loss conditions and genetics, screening guidelines, protocols for follow-up, referral networks, and therapies available.DiscussionCurrent practices in newborn hearing screening and intervention programs can be enhanced by strengthening the basic midwifery knowledge of and rationale for follow-up when newborns fail their hearing screenings. Midwives can play an integral role in optimizing hearing, speech, and family interaction by assuring that each newborn has access to the best hearing screening and referrals.

Project description:BACKGROUND:The oral health of elderly populations is a significant concern, as it is closely linked to general health and health-related quality of life. Poor oral health exacerbates oral diseases, leading to an increased risk of non-communicable diseases and self-care dependence, particularly in the elderly, worldwide. Knowledge, attitudes, and practices (KAP) play influential roles in individual oral care. However, the evidence of KAP related to oral care among the elderly is still inadequate. OBJECTIVE:This study aimed to examine KAP and their associated factors related to oral care among the elderly community. METHODS:A cross-sectional descriptive design was used. The eligible subjects were recruited, using convenience sampling and snowball sampling. RESULTS:A total of 385 elderly individuals were included, and 51.4% were women. The mean age was 71.66 (SD 6.28). Knowledge was reportedly poor, as more than 50% elderly answered several questions incorrectly. The mean attitude and practices scores were 44.94 (SD 6.33) and 68.90 (SD 10.44), respectively. There was a significant correlation among knowledge, attitudes, and practices (p < 0.001). Multivariable regression analysis revealed numerous factors had remarkably significant association with knowledge [R2 = 0.30, F (4,380) = 11.96, p < 0.001], attitudes [R2 = 0.28, F (6,378) = 9.27, p < 0.001], and practices [R2 = 0.31, F (5,379) = 12.34, p < 0.001], particularly education levels, full-time employment, and self-care independence. CONCLUSIONS:Based on the KAP theoretical model, KAP are closely interrelated. Identified factors associated with KAP are useful to understand at-risk groups. Elderly individuals at lower education levels, with poor family support and inadequate self-care independence, have poor KAP related to oral care. Therefore, this study improves insight for health promotion developers, suggesting that more attention should be paid to at-risk elderly groups' oral health. To enhance participation in dental care and improve oral care performance in the elderly, educational program containing oral health knowledge should be offered to at-risk groups. Family support and involvement are also important for improving oral care among elderly individuals.

Project description:BackgroundEssential newborn care is a wide-ranging strategy intended to improve the health of newborns by implementing appropriate interventions. Approximately in 2018, an estimated 2.5 million children died in their first month of life, which is approximately 7000, newborns every day, with about a third of all neonatal deaths occurring within the first day after birth. Even though the most cause of death is preventable the burden of neonatal death is a still high in developing countries including Ethiopia. Therefore this study is aimed to assess the level of essential newborn care practice among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia.MethodsA community-based cross-sectional study was conducted among mothers who gave birth within the past six months in Gurage Zone, Southwest Ethiopia. For the quantitative part, 624 study participants were involved by using a multi-stage sampling method. A systematic random sampling technique was to reach the study subjects. Data entry was carried out by Epi data version 4.0.0 and analysis was done by SPSS window version 24. Binary and multivariate logistic regressions were used to identify associated factors. For the qualitative part, three focus group discussions (FGD) with purposively selected 30 mothers were involved. The data were analyzed deductively by using the thematic framework analysis approach by using Open code version 4.02.ResultOverall good essential newborn care practice was found to be 41.0% [95%CI, 36.6-44.7]. Being urban residence [AOR 1.70, 95%CI: 1.03-2.79], attending antenatal care visit [AOR = 3.53, 95%CI: 2.14-5.83], attending pregnant mothers meeting [AOR = 1.86, 95%CI: 1.21-2.86], had immediate postnatal care [AOR = 3.92, 95% CI: 2.65-5.78], and having good knowledge about ENC [AOR = 2.13, 95% CI: 1.47-3.10] were significantly associated with good essential newborn care practice.ConclusionThis study indicated that the magnitude of essential newborn care practice was low. Thus, a primary health care provider should regularly provide ENC for newborns and take opportunities to counsel the mothers about ENC during pregnant mothers meeting and MCH services sessions.

Project description:Deaths during the neonatal period account for almost two-thirds of all deaths in the first year of life and 40 percent of deaths before the age of five. Most of these deaths could be prevented through proven cost-effective interventions. Although there are some recent data from sub-Saharan Africa, but there is paucity of qualitative data from Zanzibar and cord care practices data from most of East Africa. We undertook a qualitative study in Pemba Island as a pilot to explore the attitudes, beliefs and practices of the community and health workers related to delivery, newborn and cord care with the potential to inform the main chlorhexidine (CHX) trial.80 in-depth interviews (IDI) and 11 focus group discussions (FGD) involving mothers, grandmothers, fathers, traditional birth attendants and other health service providers from the community were undertaken. All IDIs and FGDs were audio taped, transcribed and analyzed using ATLAS ti 6.2.Poor transportation, cost of delivery at hospitals, overcrowding and ill treatment by hospital staff are some of the obstacles for achieving higher institutional delivery. TBAs and health professionals understand the need of using sterilized equipments to reduce risk of infection to both mothers and their babies during delivery. Despite this knowledge, use of gloves during delivery and hand washing before delivery were seldom reported. Early initiation of breastfeeding and feeding colostrum was almost universal. Hospital personnel and trained TBAs understood the importance of keeping babies warm after birth and delayed baby's first bath. The importance of cord care was well recognized in the community. Nearly all TBAs counseled the mothers to protect the cord from dust, flies and mosquitoes or any other kind of infections by covering it with cloth. There was consensus among respondents that CHX liquid cord cleansing could be successfully implemented in the community with appropriate education and awareness.The willingness of community in accepting a CHX cord care practice was very high; the only requirement was that a MCH worker needs to do and demonstrate the use to the mother.ClinicalTrials.gov: NCT01528852.

Project description:BackgroundInsecticide-treated nets (ITNs) and long-lasting insecticidal nets (LLINs) are effective for malaria prevention and are designed to provide nearly 5 years of mosquito protection. However, many ITNs and LLINs become damaged and ineffective for mosquito bite prevention within 1 to 2 years in field conditions. Non-adherence to recommended bed net care and repair practices may partially explain this shortened net longevity.MethodsUsing data from a cross-sectional study, a net care adherence score was developed and adherence to net care practices described from two regions of western Kenya. Relationships between attitudes and environmental factors that influence net longevity were measured with adherence to bed net care practices.ResultsWhile overall care practices are highly adherent particularly in the highlands, practices related to daily storage, washing frequency, and drying location need improvement in the lowlands. Seventy-seven percent of nets in the lowlands were washed < 3 months prior to the survey compared to 23% of nets in the highlands. More nets were dried in the sun in the lowlands (32% of nets) compared to the highlands (4% of nets). Different elements of care are influenced by various malaria attitudes and environmental factors, highlighting the complexity of factors associated with net care. For example, households that learned about net care from community events, that share a sleeping structure with animals, and that have nets used by adult males tend to adhere to washing frequency recommendations.ConclusionsIn western Kenya, many nets are cared for in accordance to recommended practices, particularly in the highlands sites. In the lowlands, demonstrating methods at community events to tie nets up during the day coupled with messaging to emphasize infrequent washing and drying nets in the shade may be an appropriate intervention. As illustrated by differences between the highlands and lowlands sites in the present study, should interventions to improve adherence to bed net care practices be necessary, they should be context-specific.

Dataset Information

Factors associated with newborn care knowledge and practices in the upper Himalayas.

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Factors associated with newborn care knowledge and practices in the upper Himalayas.

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