Knowledge of ASHAS in New Born Care Practices in Relation to Placental Delivery in Uttar Pradesh, India (original) (raw)
Related papers
2020
The involvement of CHWs in the state of UP has a long history since the 70s and currently it is the key strategy to percolate primary health care to the masses through the Front Line Workers like the Accredited Social Health Activists ASHA and the Angan Wadi Workers AWW . Besides the AWWs, the current lot of CHWs in UP are the ASHAs who are the daughters in law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the EAG states. UP is one such Empowered Action Group EAG state. The current study explores three crucial variables of the messages Ante Natal Care ANC , birth preparedness and newborn care. These three variables are reflected through the role of health personnel through messages in these components provided to the Recently Delivered Women RDW or mothers in four districts of UP. From the catchment area of each ASHA, two RDWs were selected who had a child in the age group of 3 to 6 months. T...
Newborn care practices and home-based postnatal newborn care programme – Mewat, Haryana, India, 2013
Western Pacific Surveillance and Response, 2014
Background: In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs) under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs). ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits. Methods: A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi-structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing. Results: We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96%) and delayed bathing (64%) were better adopted than cord care (49%), safe breastfeeding (48%), hand washing (30%), kangaroo care (20%) and eye care (9%). Cultural beliefs and traditional birth attendants influenced the mother's practices. The lack of supervision by auxiliary nurse midwives (ANM), delayed referral and transportation were the other challenges. Conclusion: Knowledge-practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA-mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.
IJISRR, 2020
The response profiles of the Recently Delivered Women on the newborn care period on the messages related to newborn care in the first month of life of the baby are dwelled upon to evolve a picture representing the entire state of UP through this article. The relevance of the study assumes significance as detailed data on the modalities of each of the messages on newborn care are available but not exclusively for the first month period of the life of the baby. The details of the Home Based Newborn Care related messages are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to each of these messages with atria analysis, the first being the recollection capacity of the RDWs, the second is whether ASHA gave the particular message 7 the third is if the RDW received the message at home. The current study is basically regarding the summary of this triad approach during the newborn care period. The newborn care period after each delivery deals with 70% how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that includes effective and timely visits to RDWs especially in the first month of the life of the baby. This would help in making their post-natal& neonatal stage safe. This is the area of newborn care message profile detailing that the current article discusses in relation to the recent delivery of the respondents. A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of apre-tested structured interview schedule with both close-ended and open-ended questions. The current article deals with 14 close ended questions with options, three aspects foreach of the HBNC messages. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study. Among the districts related to this article, the results showed that the triad profile of each message varied widely across the 4 districts. The first message was on initiating breastfeeding within an hour of birth. Here except Barabanki district, rest three districts showed better results. The next message was feeding only breast milk to the newborn up to 6 months. For this message, except for Saharanpur district, all the three other districts fared poorly. For the message on maintaining warmth of the baby to continue to keep the baby warm, Barabanki district had less than 60% of RDWs replying on the message in all the three aspects of the message. For the message on not to apply anything on the cord again Barabanki district had about half achievement in all the three aspects of the message and in rest of the districts it was more than half in all the aspects of the message. Regarding identification of danger signs, the place component was poor in Barabanki district. In the rest of the aspects of this message in all the three districts more than half of RDWs replied on the message. About the message of weighing the newborn, it was more than 65% in the rest of the districts except Barabanki district where it was poor in all the three aspects of the message. Similarly, for the message on delaying bathing up to one week, it was less than 50% across in Barabanki district and less than 60% in Gonda district in receiving the message from ASHA and at home. The message on telling the RDW to take to a health facility in case of health problem of a newborn showed that the ASHAs in Barabanki district had done the message delivery very poorly. Similarly, the ASHAs of Barabanki district had done poorly for the message on contraception/family planning services. In all the three aspects of the message on caring equally for boy or girl, the ASHAs of Barabanki district had delivered the message to just about more than half of RDWs in all the three aspects of the message. Regarding the message on skin to skin care, the ASHAs of Barabanki district lagged behind among the ASHAs of 4 districts in delivering the message. In Barabanki and Gonda districts, about 60% RDWs replied in all the three aspects of the message on maternal nutrition. Finally, it was evident that only with the use of job aides the message delivery could be effective but ASHAs particularly in Barabanki and Gonda districts did not cover all the RDWs to deliver messages through job aides on newborn care.
International Journal Of Community Medicine And Public Health
Background: Knowledge and practices of postnatal mothers is very crucial in providing care to newborns. Aim was to assess determinants of the knowledge and practices of postnatal mothers on essential newborn care.Methods: A community based cross-sectional study was conducted among 150 postnatal mother - neonate dyads in one of the selected Primary Health Centres (PHC) of rural Haryana. A self-developed, pre-tested and validated structured interview schedule containing socio-demographic, clinical profile information and a knowledge and practice questionnaires (α-0.79, 0.86) having 38 multiple choice questions (MCQs) and 28 items respectively were used for data collection covering various aspects of essential newborn care such as thermal care, breastfeeding, cord care, eye care, handwashing, and danger signs. Results: More than half (52%) of the postnatal mothers had moderate knowledge and 76.7% of postnatal mothers reported of adequate practices. Gaps were identified in terms of know...
NJAR, 2020
The current article of Uttar Pradesh (UP) is about the ASHAs who are the daughters-in-law of a family that resides in the same community that they serve as the grassroots health worker since 2005 when the NRHM was introduced in the Empowered Action Group (EAG) states. UP is one such Empowered Action Group (EAG) state. The current study explores the actual activities done by Recently Delivered Women (RDW) on three activities related to newborn care. These are dry, wrap, colostrum feeding and cord cutting of the newborn. From the catchment area of each ASHA, two RDWs were selected who had a child in the age group of 3 to 6 months during the survey. The action profiles of the RDWs on these aspects of newborn care are reflected upon to give a picture that represents the entire state of UP. The relevance of the study assumes significance as data on the modalities of actual actions done by the RDWs for their last delivery are not available even in large scale surveys like National Family Health Survey 4 done in 2015-16. The current study gives an insight in to these activities separately. The current study is basically regarding the summary of three actions on newborn care done & replied by RDWs during their post-natal stage. When late or poor newborn care actions are taken by the RDWs and their family members, it shows up poorly in the Neonatal Mortality Rate (NMR) & there by impacting the Infant Mortality Rates (IMR) in India and especially in UP. The current IMR in India is 33 where as it is 41 in UP which means 8 points higher per 1000 livebirths (SRS, May 2019). Similarly, the current NMR in India is 23 per 1000 livebirths (UNIGME,2018). As NMR data is not available separately for states, the national level data also hold good for the states and that's how for the state of UP as well. These mortalities are the impact indicators and such indicators can be reduced through long drawn processes that includes effective and timely actions on newborn care by RDWs in their deliveries. This is the area of actions detailing that the current study throws out in relation to placental delivery. A total of four districts of Uttar Pradesh were selected purposively for the study and the data collection was conducted in the villages of the respective districts with the help of a pre-tested structured interview schedule with both close-ended and open-ended questions. In addition, in-depth interviews were also conducted amongst the RDWs and a total 500 respondents had participated in the study. The results showed that 98% RDWs in Gonda and all the RDWs in the other 3 districts replied that they dried their baby immediately and before placental delivery. Regarding wrapping, only 1% RDW in Gonda wrapped the baby after an hour or more after placental delivery. Rest of the RDWs in all the 4 districts wrapped the baby immediately before placental delivery. The results also showed that the ASHAs were not following up effectively for Early Initiation of Breast Feeding (EIBF) in the 3 districts other than Banda. This EIBF indicator also showed poor performance of ASHAs in Gonda and Barabanki districts. For cord cutting indicator, the practices of RDWs showed that among the deliveries conducted by the ANMs and the home deliveries, the cutting of the cord was delayed in relation to placental delivery.
Newborn care practices of mothers in rural areas of Navsari district
International Journal of Medical Science and Public Health, 2014
Background: Newborn mortality is one of the world's most neglected health problems. It is estimated that globally four million newborns die before they reach 1 month of age and another four million are stillborn every year. Aims & Objectives: (1) To study the maternal care in terms of Antenatal, Intranatal and Postnatal care practices; (2) To assess newborn care practices in rural areas. Materials and Methods: A cross-sectional study in rural areas of Navsari district, Gujarat, included 243 women who had one child aged 12 to 23 months preceding data collection. Data were analyzed using statistical software Epi Info 6. Results: All the mothers under study had adequate ANC checkups. All the mothers had received Iron supplements during ANC but 72.8% of them completed it for 3 months. Majority (99.2%) had institutional delivery. Regarding thermal care practices, half of the women reported that the baby was dried and wrapped within 15 minutes of birth. More than one third (37.8%) of babies were bathed in less than 24 hours of birth. Most of the mothers (93.4%) had put substances on the umbilical cord. About 32% of the infants had received pre-lacteals feeds. The colostrum was fed by 90.9% of mothers. Only 56.4% mothers initiated breast-feeding within 1 hour of birth. Conclusion: In majority of cases, correct practices regarding newborn care were observed among mothers and this should be promoted through improved coverage with existing health services.
Role of Ashas in Tracking Deliveries and Newborns in Uttar Pradesh, India
2018
When ASHAs were introduced in NRHM in 2005, their primary aim was to visit homes of newborns as the first program in UP operated through the ASHAs was the Comprehensive Child Survival Program in 2008. Since then, tracking of all deliveries and all the newborns are an integral part of the work of ASHAs in all the primary health care programs operated by the NHM in UP. The current study explores some of the crucial variables of the targeted activities of the ASHAs in absolute numbers in four districts of UP. Through this profile, the average number of deliveries in the coverage area of ASHAs, tracking of both institutional and home deliveries by ASHAs, number of deliveries escorted by ASHAs in the last 3 months prior to the survey and the number of newborns that they covered through home visits. The relevance of the study assumes significance as data on the details of targeted activities done by ASHAs in comparison to their performance are usually not available in various studies. A...
International Journal of Current Research and Academic Review, 2017
Article Info Every year 4 million babies die in the first month of life and a quarter of these takes place in India. Essential new born care and proper breastfeeding practices have a proven impact on reducing the infant mortality rate. This study was conducted with the aim to assess the knowledge regarding essential new born care among women availing antenatal services. A cross-sectional study was conducted among women availing antenatal care services at a maternity hospital in a rural area of South Karnataka. A face-validated structured interview was administered to 201 women and data were analyzed. There was overall poor knowledge regarding essential newborn care and breastfeeding practices among women in the area of study. As the parity of the women increased, they scored better in the newborn care and the breastfeeding questionnaire. Conclusion and recommendation: The knowledge and access to knowledge among rural women regarding newborn care practices and breastfeeding was poor. Health education regarding newborn care practices should be imparted to new mothers, relatives and adolescent girls because adequate knowledge among mothers is the first step to the practice of good breastfeeding and essential new born care.
Factors associated with newborn care knowledge and practices in the upper Himalayas
PLose One , 2019
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.