Assessing neonatal care practices in rural Nepal (original) (raw)

Cross sectional, community based study of care of newborn infants in Nepal

BMJ (Clinical research ed.), 2002

To determine home based newborn care practices in rural Nepal in order to inform strategies to improve neonatal outcome. Cross sectional, retrospective study using structured interviews. Makwanpur district, Nepal. 5411 married women aged 15 to 49 years who had given birth to a live baby in the past year. Attendance at delivery, hygiene, thermal care, and early feeding practices. 4893 (90%) women gave birth at home. Attendance at delivery by skilled government health workers was low (334, 6%), as was attendance by traditional birth attendants (267, 5%). Only 461 (8%) women had used a clean home delivery kit, and about half of attendants had washed their hands. Only 3482 (64%) newborn infants had been wrapped within half an hour of birth, and 4992 (92%) had been bathed within the first hour. 99% (5362) of babies were breast fed, 91% (4939) within six hours of birth. Practices with respect to colostrum and prelacteals were not a cause for anxiety. Health promotion interventions most li...

Papers Cross sectional, community based study of care of newborn infants in Nepal

Objective To determine home based newborn care practices in rural Nepal in order to inform strategies to improve neonatal outcome. Design Cross sectional, retrospective study using structured interviews. Setting Makwanpur district, Nepal. Participants 5411 married women aged 15 to 49 years who had given birth to a live baby in the past year. Main outcome measures Attendance at delivery, hygiene, thermal care, and early feeding practices.

Newborn Care Practices in Rural Community of Palpa District, Nepal

2017

Background: Newborn care is of immense importance for the proper development and healthy life of a baby. The first 28 days of life is known as the newborn or neonatal period. It is the most complicated period in the life. Objective: To find out the home based newborn care practices and assess the practices during home delivery. Methods: A community-based cross-sectional study was carried out in Palpa district on a sample of 150 lactating mothers who have delivered within the past 6 months. Results: It was observed that most of the respondents (80.0%) had not any types of health problems during pregnancy. More than three quarter (88.0%) deliveries took place in institution and 12.0 per cent at home. Around half of respondents (56.7%) bathed the baby after 24 hour of birth, followed by around one third (38.0%) within 1-24 hours of birth and 5.3 per cent bathed within 1 hour. Around three quarter of the respondents (75.3%) had introduced breastfeeding within 1 hour. Similarly, majority...

Factors Associated with Maternal and Neonatal Health Care Practices: A Study from Nepal

https://www.ijhsr.org/IJHSR\_Vol.10\_Issue.2\_Feb2020/IJHSR\_Abstract.029.html, 2020

Background: Maternal and neonatal health problem is a major public health burden. Most of the newborn deaths in the developing countries occur due to lack of access to care. The main objective of the study was to assess and identify the factors associated with maternal and neonatal health care practices in Chitwan, Nepal. Methods: An analytical & descriptive cross-sectional study was conducted among 157 mothers having a child below one year. Results: The study showed that the mean age of the mothers and mean age during the marriage was 24 years. Almost all the mothers had used safe delivery kit (97.5%). Almost all of the mothers applied the substance on the umbilical cord with the application of Chlorhexidine on the umbilical cord found to be 98.4%. Bathing time after 24 hrs., breastfeeding within 1 hour, colostrum feeding was found to be 94.3%, 69.4% & 96.2% respectively. Place of the delivery, education status, maternal age, and delivery types are the associated factors with neonatal health care practices whereas bathing time was not found significant. Conclusion: Neonatal health care practices are still not satisfying and poor. In rural areas, there is a more prevalent of poor and unsafe neonatal health care practices. Health programs focusing on mothers and more research works should be conducted to promote safe neonatal health care practices in low income developing countries.

Neonatal mortality and child health in a remote rural area in Nepal: a mixed methods study

BMJ Paediatrics Open, 2019

ObjectiveTo assess neonatal and under-five mortality and the health situation for children in Dolpa, a remote rural area of Nepal.Study designMixed methods: quantitative (retrospective cross sectional) and qualitative (semistructured interviews).RationaleProgress in reducing child and newborn mortality in Nepal has reached the remote areas to a limited extent. Furthermore, there may be substantial under-reporting and data may be unreliable.Setting and participantsThe population of Dolpa district is approximately 35 000. We visited 10 randomly selected villages (plus one settlement) with approximately 12 000 inhabitants.MethodologyRecords of the number of deliveries, neonatal and under-five deaths were collected. 100 children (10 different villages) were evaluated for common diseases present during the month prior to the investigation. 20 interviews were conducted about the cultural perceptions of neonatal death and morbidity; in each village at least one interview was undertaken.Res...

Determinants of Immediate Essential Newborn Care Practice in Eastern Rural Nepal

International Journal of Child Health and Nutrition,, 2013

Neonatal mortality remains high in Nepal. Improvement in immediate essential newborn care practices such as "use of clean instrument to cut the umbilical cord ", "drying and wrapping the baby before placenta was delivered", "initiation of breastfeeding within an hour of delivery" and "first bathing of neonate after 24 hours of delivery" can reduce neonatal deaths. However, this can only be accomplished if factors associated with reduced neonatal mortality can be identified. A regional study was carried out with 252 randomly selected women having child aged 11 months or younger; of which about 70 percent, 18 percent and 20 percent had received delivery assistance with skilled birth attendant, trained health professional and untrained friend/relatives respectively. Skilled Birth Attendant appeared as the determinant of the use of clean instrument to cut the umbilical cord (OR=164.33), first bathing of neonate after 24 hours of delivery (OR= 5.14) and drying and wrapping the baby before placenta was delivered (OR= 50.75) whereas Trained Health Professionals turned out to be the determinant of the use of clean instrument to cut the umbilical cord (OR=3.81) and first bathing of neonate after 24 hours of delivery (OR=3.14) only (Reference: Untrained relatives/friends). Maternal age (OR= <20:10.59 and 20-30: 6.39; Ref: >30 years) and education (OR=Primary-21.81; Secondary-20.11; Ref-Higher) appeared the determinant of initiation of breastfeeding within an hour of delivery. The time gap between delivery and the mother receiving the baby was also significantly positively associated with initiation of breastfeeding within an hour of delivery. This result indicates the need to increase the coverage of health facilities which can provide SBA, empower women to involve a SBA in delivery and provide newborn care education to women and family members. In order to better understand how to decrease neonatal mortality, further study should focus on understanding why there were better newborn care practices in births assisted by a SBA than THPs.

Newborn Care Practices in Rural Communities of Nawalparasi District, Nepal

Online Journal of Health and Allied Sciences, 2013

Most of the new born deaths in the developing countries occur due to lack of access to care, as majority of the deliveries occur at home. Even deliveries conducted in health facilities are prone to suffering from traditional care practice after discharge from health facilities. Most of these deaths could be avoided with changes in antenatal, delivery and newborn care practices. This study was conducted to explore the newborn care practices related to cord care, thermal care and breast feeding in rural setting and to identify socio-demographic, antenatal and delivery care factors associated with these practices. A cross sectional study in rural setting of Nawalparasi district included 296 women who had delivered live baby at home or discharged within 24 hours of delivery from hospital proceeding four months of data collection. Chi squire test was applied to compare sociodemographic, antenatal and delivery care factors associated with cord care, thermal care and breast feeding practices. Of the total 296 mother interviewed, only 65.54% have completed ANC visit at least 4 times and 29.05% have received counselling on newborn care during pregnancy. More than half deliveries (53.38%) were home deliveries and Clean Home Delivery Kit was used only one third (39.91%) of these deliveries. Of the three selected newborn care practices, clean cord keeping practice was found in only one fourth (25.70%) of deliveries. However early initiation of breast feeding and delayed bathing practice was found in about half of the deliveries (51.35% and 58.45% respectively). There is strong need to implement the community-based interventions to improve the new born care practices in community level and to reduce the high-risk newborn care practices like unsafe cord care, delayed breast feeding, early bathing, prelacteal feeding and discarding colostrum need through the community level health workers and volunteers.

Newborn Care Practices in a Jhangad Community of Eastern Nepal

2015

Background: Clean delivery and clean cord care are used for the prevention of newborn infections, especially tetanus and sepsis. Objectives: The objective of this study was to explore neonatal care practices in relation to home delivery in a Jhangad community of Eastern Nepal and to identify a relationship of sociodemographic characteristics of mothers who recently delivered at home with neonatal care practices. Materials and methods: The Lot Quality Assurance Sampling (LQAS) technique was applied. Participants included 162 mothers of the Morang and Sunsari districts of Eastern Nepal who recently delivered newborns. Results: Of the respondents, 69.1% were illiterate, 82% were wage laborers and 53% were living in a joint family. Clean cord care was found in 79.6% of home deliveries. The stump of the umbilical cord was left undressed in 85.2% of deliveries. The majority of newborns, 76.5%, were bathed within 24 hours of their birth. About 11.7% of deliveries were conducted on a plastic sheet, 59.9% on an old mat and 28.4% on open ground. Good thermal care was only found in 1.2% of the newborns. Good breast feeding practice was found in 29.6% of the mothers. Roughly 32.7% of mother's breast fed immediately after childbirth and about 60% practiced pre-lacteal feeding. Conclusion: Delayed wrapping, bathing within one hour, cord application, delayed breastfeeding and pre-lacteal feeding were common high-risk practices in the Jhangad community. Practices concerning home delivery and neonatal care are based on deep-seated traditional beliefs and ignorance.

Factors associated with neonatal deaths in Chitwan district of Nepal

BMC Research Notes, 2015

Background: Neonatal mortality has remained unchanged since 2006 in Nepal. Reducing neonatal mortality is indispensable to reduce child mortality. The objective of this study was to investigate the factors associated with neonatal mortality. This study assesses socio-demographic factors, maternal health care and newborn care practices contributing to neonatal deaths in Chitwan district of Central Nepal. Methods: A case-control study was conducted during April-July 2012. The study used a mixed-method approach, in which records of neonatal deaths were obtained from the District Public Health Office and a comparison group, survivors, was obtained from the same community. A total of 198 mothers (of 99 neonatal deaths and 99 survivor neonates) were included in the survey. Focus group discussions, in-depth interviews and case studies were also conducted. Maternal characteristics were analyzed using descriptive statistics, Mc Nemar's Chi square test and multivariable backward conditional logistic regression analysis. Qualitative data were analyzed by narrative analysis method. Results: More than four-fifth of mothers (86 %) had antenatal checkup (ANC) and the proportion of four or more ANC was 64 %. Similarly, the percentage of mothers having institutional delivery was 62 %, and postnatal checkup was received by 65 % of mothers. In multivariable analysis, low birth weight [adjusted odds ratio: 8.49, 95 % CI (3.21-22.47)], applying nothing on cord [adjusted odds ratio: 5.72, 95 % CI (1.01-32.30)], not wrapping of newborn [adjusted odds ratio: 9.54, 95 % CI (2.03-44.73)], and no schooling of mother [adjusted odds ratio: 2.09, 95 % CI (1.07-4.11)] were significantly associated with an increased likelihood of neonatal mortality after adjusting for other confounding variables. Qualitative findings suggested that bathing newborns after 24 h and wrapping in clean clothes were common newborn care practices. The mothers only attended postnatal care services if health problems appeared either in the mother or in the child. Conclusion: Results of this study suggest that the current community based newborn survival intervention should provide an even greater focus to essential newborn care practices, low birth weight newborns, and female education.

Home Care Practices for Newborns in Rural Southern Nepal During the First 2 weeks of Life

Journal of Tropical Pediatrics, 2012

The provision of essential newborn care through integrated packages is essential to improving survival. We analyzed data on newborn care practices collected among infants who participated in a community-based trial in rural Nepal. Analysis focused on feeding, hygienic, skin/cord care and thermal care practices. Data were analyzed for 23 356 and 22 766 newborns on Days 1 and 14, respectively. About 56.6% of the babies were breastfed within 24 h and 80.4% received pre-lacteal feeds within the first 2 weeks of life. Only 13.3% of the caretakers always washed their hands before caring for their infant. Massage with mustard oil was near universal, 82.2% of the babies slept in a warmed room and skin-to-skin contact was rare (4.5%). Many of these commonly practiced behaviors are detrimental to the health and survival of newborns. Key areas to be addressed when designing a community-endorsed care package were identified.