Care-seeking practices for sick neonates: Findings from cross-sectional survey in 14 rural sub-districts of Bangladesh

Abstract

ObjectivesNeonatal deaths account for 45% of all under-five deaths globally and 60% in Bangladesh. This study aimed to investigate the most common symptoms and complications in neonates, care-seeking practices of the mothers for their sick neonates, and factors associated with the care-seeking practices.MethodsThis cross-sectional study analysed data from an Endline Household Survey (as part of an evaluation of a paired cluster-randomised controlled trial study in 14 rural sub-districts in Bangladesh) of 2,931 women who gave birth recently. Descriptive analysis and logistic regressions were conducted to identify the care-seeking practices of mothers of sick neonates and the factors associated with the care-seeking from trained providers.ResultsOf the 2868 neonates, 886 (30.9%) were reported ill during first 28 days after birth. For those with reported symptoms, 748 (84.4%) of their mothers sought care. Of those who sought care, 65.2% sought care from untrained providers. Multiple logistic regression analysis showed significantly higher odds of care-seeking from trained providers when neonates had 3 or more concurrent symptoms (OR: 1.82; 95% CI: 1.07–3.08); when mothers perceived their neonates’ symptoms as severe (OR: 4.08; 95% CI: 2.92–5.70); when mothers received skilled care during pregnancy (OR: 1.95; 95% CI: 1.34–2.84); and when mothers had their delivery in a facility (OR: 3.50; 95% CI: 2.18–5.62). Mothers who delivered their babies at a facility, 43.1% of them sought care for their sick neonates at the same type of public hospital and 34.9% from same type of private hospitals where their deliveries took place.ConclusionSkilled care for mothers during pregnancy and delivery, and mothers’ perceptions of the severity of symptoms are the key associated factors of care-seeking for sick neonates from trained providers. Interventions should be tailored to increase care from trained providers during pregnancy and delivery at facilities to improve care-seeking for neonates from trained providers and for the survival of neonates.

Prevalence, care-seeking behaviors and treatment cost for neonatal morbidities in Karnataka (India)

“…Further, the results shows that the majority (nine out of ten) of the mothers in this study reported of receiving care for their sick neonates from health-care providers, which is again consistent with other recent studies (Chowdhury et al, 2018), and much…”

The Profile, Health Seeking Behavior, Referral Patterns, and Outcome of Outborn Neonates Admitted to a District and Regional Hospital in the Upper West Region of Ghana: A Cross-Sectional Study

“…Neonates with danger signs, such as fever, distended abdomen, and difficulty in breathing, were more likely not to delay reaching the neonatal unit. Most parents were able to recognize danger sign symptoms as other studies have also demonstrated [8,11,14,25,26]. All these signs can be associated with an infection; although, bleeding in newborns was most commonly caused due to hemorrhagic disease of the newborn [27,28].…”

“…Premature babies comprised of 17.0% (26). Home visits were reported by 21.9% (32) of mothers, and 57.1% (16) of these visits were done by community health nurses, 39.3% (11) were done by community health volunteers, 3.6% (1) were done by a midwifes, and two did not specify the category of health staff who performed home visits. Table 1 provides a summary of the characteristics of the neonates that were referred to the hospital and their mothers.…”

“…Several factors influence newborn health and the care seeking behaviors of their caregivers [5,7]. This ranges from the awareness of danger signs, essential newborn care practices, personal and communal beliefs, health and socio-cultural practices, as well as financial and physical access to health services [5,[7][8][9][10][11]. The level of service that is readily available close to them can also affect health [9,10,12].…”

“…The level of service that is readily available close to them can also affect health [9,10,12]. Thus, the robustness of the referral system, the type of care that is available, and the providers at each level, from home to hospital, are important determinants of neonatal outcome [1,[11][12][13][14][15]. We examined the health practices, care seeking behavior, and selected aspects of the processes involved in the referral of outborn neonates to a district and a regional hospital in the Upper West Region of Ghana, the region with the most rural population during the last census in 2010, in order to identify care barriers in this and similar settings.…”