Objectives Our objective was to assess changes in prelacteal feeding practices in rural Bangladesh over a 15-year period, from ∼2004 to ∼2019, and to identify household, maternal, and infant characteristics associated with that trend. Methods The analysis used data from 21,804 infants enrolled in a cluster-randomized controlled trial of newborn vitamin A supplementation from 2004–2006, and from 4631 infants enrolled in a cluster-randomized controlled trial of a digital health intervention from 2018–2019. In both studies, trained field workers collected data on household socioeconomic status and maternal demographic characteristics at the time of enrollment. Upon receiving notification of an infant's birth, field workers visited the home as soon as possible, collecting detailed data on breastfeeding initiation and any foods or liquids other than breast milk provided to the infant. Prelacteal feeding was defined as giving infants any food or liquid other than breast milk within first 3 days of life. We used bivariate and multivariate logistic regression analyses to examine the association between different household, maternal, and infant characteristics and prelacteal feeding. We then applied a regression decomposition method to understand the factors associated with the changing prevalence of prelacteal feeding over time. Results The prevalence of prelacteal feeding was 88.0% during the period of 2004–2006. Among women practicing prelacteal feeding, sugar/sugar candy water was the most commonly fed prelacteal (41.2%), followed by animal milk (40.0%), honey (35.4%), and drops (11.8%). By 2018–2019, the prevalence of prelacteal feeding had declined to 24.7%. Most frequently consumed prelacteals were most commonly sugar/sugar candy water (20.0%), honey (20.0%), animal milk (19.7%), and drops (14.3%). Final analysis will include examination of the changing factors associated with this decline including rising maternal education, improvements in socioeconomic status, and exposure to media. Conclusions The prevalence of prelacteal feeding has dropped considerably in rural Bangladesh since 2004. Funding Sources The Bill and Melinda Gates Foundation; United States Agency for International Development; Sight and Life.

In developing countries, most deliveries take place without a skilled birth attendance. This lack of skilled birthattendance could be considered as one of the major factors contributing to maternal and neonatal morbidity and mortality. The use of facility-based delivery system helps to reduce various complications during childbirth, which may be affected by social and cultural norms among several other factors. This study was to assess the proportion of pregnant women delivering at home and the role of socioeconomic and demographic factors affecting the choice of place of delivery among pregnant women attending antenatal, postnatal and Immunization clinic at Rano General Hospital, Kano. This is a cross sectional study carried out between September 2018 to November 2018 among 310 pregnant women who had at least delivered once and are attending antenatal care, post-natal or immunization clinic at the General hospital in Rano local government area of Kano state within the study period. Data was collected using interviewer administered questionnaire which was interpreted to those participants who cannot understand English language. Data obtained was entered into excel spread sheet 2018 and subsequently analyzed using SPSS 2016 version 20. Multivariateregression methods were used for measuring the associations between socio-demographic variables and place of delivery. About 310 questionnaires were distributed of which 100% retrieval rate was achieved. A total of 281 (90.6%) received antenatal services at least once during their previous pregnancy among which 183 (59.03%) of them had home delivery. The respondents were between the ages of 18-37 years with the mean age of 24.9 ± 5.1 years. Minimum age of the respondents was 18 years, while the maximum age was 37 years. The main reasons for home delivery were, previous delivery was at home and complication free, short interval between onset of labor and delivery and also husband and mother in-law's decision. This study has shown that there is still high rate of home delivery among antenatal clinic attendees. This home delivery is usually preferred to hospital delivery by their husbands and mother in-laws as they consider it to be safe and more convenient. There is therefore need to educate women on early signs of labor and address the importance of health care delivery to prevent complications which may increase the maternal mortality rate.