Community’s perception, experiences and health seeking behavior towards newborn illnesses in Debre Libanos District, North Shoa, Oromia, Ethiopia: Qualitative study

Abstract

Background Worldwide about 4 million newborns die each year; of which around 600,000 newborns die from series bacterial infections. To reduce newborn death, community based newborn care is being implemented in Ethiopia though its utilization by clients is low. Studies conducted to address perception of the community towards newborn illnesses are limited. Therefore, this study was aimed in exploring community member's perception, experiences and health seeking behavior towards newborn illnesses. Methods A descriptive qualitative study was conducted from March 11-April 7, 2019 in Debre Libanos District, Ethiopia. Study participants were recruited purposively from six kebeles and women delivered within two months prior to data collection were the primary study participants. Five in-depth interviews, seven key informant interviews and three focused group discussions were conducted. Data were audio-recorded, transcribed verbatim, translated, and analyzed using inductive thematic analysis in Atlas ti.7.1 software package. Result This study found that community members locally diagnose newborn illnesses as sunburn, evil eye, kichitat, megagna, berd, enlarged/dropping of uvula, and common cold from misconceived cause when unspecific types of symptoms are recognized on newborns. For those locally diagnosed newborn illnesses, they primarily prefer traditional medications to manage the illnesses rather than seeking care from health facilities. This study also found that clients seek health care for these newborn illnesses late. They seek care either from traditional or from health facilities when newborns become unable to breast feed, weak and feeling too hot.

Exploration of facilitators of and barriers to the community-based service utilization for newborn possible serious bacterial infection management in Debre Libanos District, Ethiopia: descriptive qualitative study

“…This local illness diagnosis makes the community members perceive that newborn illnesses have no medical treatment from health facilities, and rely on the traditional medicines rather than seeking care from health facilities; developing misconception on treatment options. These findings are consistent with the findings of studies conducted in central and southern Ethiopia, Nigeria, and Bangladesh in that community members use herbal medicine to treat newborn illnesses [23][24][25][26][27][28]. This study also found that community members perceive newborn illnesses as non-severe which resolve spontaneously within a few days.…”

“…This study also found that community members perceive newborn illnesses as non-severe which resolve spontaneously within a few days. This finding is consistent with findings from different studies conducted at different settings in that community members in those settings delay sought health care from health facilities due to expectation of self-resolution [28,29] and considering the symptoms as minor that resolve within next few days [28,30]. This calls a need to conduct a behavioral change communication to change the behavior of the community members towards newborn illnesses and their treatment.…”

“…Thus, HEWs are responsible to provide a home to home PNC service on the first, third, and seventh day to identify and treat illnesses in newborns with amoxicillin and gentamycin [9,18,27]. On the other hand, conducting pregnant women conference is used to promote the service and facilitates in developing health care seeking newborn illnesses [28]. Nevertheless, the result from this study showed that there were no pregnant women conducted for the last 3 years, and HEWs did not provide PNC service on these critical days which might result in addressing sick newborns to screen for danger signs and sign and symptom of PSBI.…”

Exploring communities’ perceptions of the etiology of illnesses in newborns and young infants 0–59 days old in 4 counties in Kenya

“…Erroneous beliefs about causes of illnesses in SYIs such as linking illnesses to a child's given name were also common. Our findings are similar to studies conducted elsewhere in low-and middle-income countries where illnesses or death to children have been attributed to PLOS ONE the 'evil eye' or malevolent spirits [7,10,[29][30][31]. A study in the Ashanti Region of Ghana revealed how caregivers attributed pregnancy loss and newborn mortality to a local illness called asram-believed to be caused by evil spirits [11].…”

“…A similar finding have been noted in qualitative studies conducted in Ghana and Nigeria [25,26]. While illness conceptualization play an important role in the decision regarding treatment options [27,28], knowledge of biomedical causes alone may not lead to healthcare-seeking from facilities in settings where traditional beliefs are pervasive [29,30]. There is need for interventions to reinforce correct beliefs about causation and treatment of illnesses in SYIs to promote care-seeking from health facilities.…”