Newborn care practices in low socioeconomic settlements of Karachi, Pakistan

Fikree, Fariyal F.; Ali, Tazeen Saeed; Durocher, Jill; Rahbar, Mohammad Hossein

doi:10.1016/j.socscimed.2004.06.034

Cited by 117 publications

(136 citation statements)

References 24 publications

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“…We found one study reporting cord-cutting and newborn washing practices in Sindh; 15 one reporting 'eating down' in pregnancy to avoid a large baby; 16 and two documenting similar reasons for preferring home delivery, 17,18 that is, access, quality and modesty. The most comparable study was SC's positive deviance inquiry of newborn care in Bagra Union Council in Haripur district in January 2001.…”

Section: Discussionmentioning

confidence: 95%

Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

et al. 2007

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Objective: To learn about household maternal and newborn health knowledge and practices to aid the design of newborn programming within Save the Children's Haripur Program.Study Design: In April, we conducted 43 semi-structured interviews (SSIs) and 34 focus group discussions among men, women of reproductive age and health service providers; in September, we added 21 SSIs among new mothers, new fathers and dais. Two investigators analyzed the findings according to themes within six care types: antenatal, delivery, immediate newborn, routine postpartum, special maternal and special newborn.Result: Findings indicated poor maternal diet and antenatal careseeking. Home delivery with an untrained dai was the norm. Respondents knew about benefits of clean delivery, but rarely put knowledge into practice. Knowledge and practices for maintaining the newborn's warmth were good. Delayed initiation of breastfeeding, avoidance of colostrum and prelacteal feeding were almost universal. Unhygienic cord care, including an unclean cut and application of ghee on the cord-stump, was the norm. After delivery, mothers often maintained low fluid intake but otherwise reported healthy nutritional practices. Knowledge of some danger signs in newborns was common, but timely action upon recognition was not. Conclusion:Although the findings illustrate some beneficial practices, many reported practices are harmful to the newborn. These findings, consistent with the sparse existing data in Pakistan, inform program interventions for household-level behavioral change.

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Section: Discussionmentioning

confidence: 95%

Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

et al. 2007

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“…Another Indian study done in Meerut, Haryana by Sinha et al also reported that the knowledge and skills of health workers were moderate regarding the umbilical cord care [5]. Various studies done worldwide among the postnatal mothers reported the use of some unsafe materials on the newborn's umbilical cord [6][7][8]. These findings necessitate the presence of trained health-care workers in home-based normal vaginal deliveries, and the health workers who lack adequate knowledge need to be given sufficient training and education to prevent complications due to improper umbilical cord care.…”

Section: Discussionmentioning

confidence: 99%

Knowledge of Government and Private Primary Health Care Workers on Newborn Care Components: A Questionnaire-Based Cross-Sectional Comparative Study

Jayabal

Thaniarasu

2017

Asian J Pharm Clin Res

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Objective: This study was done to evaluate the knowledge of primary health-care workers about the newborn care components. Methods:The Institutional Ethics Committee approval was obtained, and a cross-sectional study was carried out among the primary health-care workers of Karaikal using a pretested questionnaire from January 2015 to March 2015. The questionnaire contained questions on various domains of newborn care components. The study participants were explained about the study. Verbal informed consent was obtained, and the questionnaire was introduced to 383 health-care workers. The answered questionnaires were collected and analyzed.Results: A total of 349 participants (192-government employees; 157-private employees) were willing to take part in the study. Most (54.7%) of the government participants were nurses and auxiliary nurse midwives (43.2%) whereas the private sector participants were predominantly (79%) nurses. The knowledge level about some of the newborn care components, namely, positioning and attachment, advice on discharge, time of follow-up checkup, bad child rearing practices, and danger signs of newborn were assessed to be predominantly inadequate among a majority of health workers of both sectors. 22.29% and 41.1% of the private health-care workers and government health-care workers respectively, were having an overall adequate knowledge (overall score >75%) on newborn care components. Knowledge of the government health workers was significantly better than private health-care staff (P < 0.001). Conclusion:Knowledge is found to be inadequate among health-care workers on some newborn care components which necessitate measures to improve.

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“…Early bathing is common, sometimes with vigorous scrubbing of the skin to remove the vernix, especially when local knowledge dictates that the vernix is a 'dirty' or polluting substance. 47,78 Early bathing can increase the risk of hypothermia, despite the use of warm water and STSC. 58 Forceful removal of vernix disrupts the skin barrier, and leads to skin cooling due to increased transepidermal water loss through the compromised skin barrier.…”

Section: Transportmentioning

confidence: 99%

Neonatal hypothermia in low resource settings: a review

et al. 2009

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Background: Hypothermia is increasingly recognized as a major cause of neonatal morbidity and mortality in resource poor settings. High prevalence of hypothermia has been reported widely from warmer high mortality regions of Africa and South Asia. The World Health Organization recognizes newborn thermal care as a critical and essential component of essential newborn care; however, hypothermia continues to remain under-documented, under-recognized and under-managed.Objective: This review aims to provide a thorough patho-physioepidemiological discussion of neonatal hypothermia applied to local risk factors within the developing country context with particular emphasis on prevention, recognition and management.Method: All available published literature on neonatal hypothermia relevant to resource poor settings were reviewed. Studies from the developing country settings were primarily reviewed for epidemiology, domiciliary risk factors as well as potential interventions for thermal care.Result and Discussion: Functional integrity and efficiency of biological systems is critically dependent on an optimal and very narrow range of core body temperature. Risk factors for neonatal hypothermia differ markedly within low resource settings. A combination of physiological, behavioral and environmental factors universally put all newborns, irrespective of birth weight, at risk of hypothermia. The knowledge deficit along the continuum from health providers to primary care givers has sustained the silent epidemic of hypothermia. The challenges of recognition, understanding of local risk factors and communication have meant a lack of informed thermal care for newborns. Simple, feasible interventions exist, but need to be applied, based on local risk factors that disrupt the warm chain. Further research is needed to document local risk factors, develop better techniques for recognition, evaluation of thermal care within essential newborn care and communication strategies for program effectiveness. Keywords: hypothermia; skin-to-skin care; warm chain; community; newborn; neonatal health Introduction 'If a definition of life were required, it must be most clearly on that capacity, by which the animal preserves its proper heat under the various degrees of temperature of the medium in which it livesy a few degrees of increase or diminution of the heat of the system, produces disease and death' said James Currie some two centuries ago, recognizing the central importance of temperature regulation in health. 1 Although folklore associated with increased temperature or fever has been recorded throughout history across virtually every culture and civilization, a recognition of hypothermia and its clinical significance, particularly for newborn health is a relatively recent advance. 1,2 Moreover, progress toward thermal care of newborns in developed countries has far outstripped knowledge and practice in developing country settings, where 99% of global neonatal deaths occur. 3,4 Hypothermia during the newborn period is widely regarded as a...

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Newborn care practices in low socioeconomic settlements of Karachi, Pakistan

Cited by 117 publications

References 24 publications

Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

Knowledge of Government and Private Primary Health Care Workers on Newborn Care Components: A Questionnaire-Based Cross-Sectional Comparative Study

Neonatal hypothermia in low resource settings: a review

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