Parent-Carer Education: Reducing the Risks for Neonatal and Infant Mortality

Abstract

In this chapter, the role of engaging parents, family members, partners, significant others and carers (subsequently referred to as parent-carers) as key partners in targeted strategies for reducing the risks associated with neonatal mortality is discussed, especially within the context of less resource-constrained environments. Parent-carer education, sharing information on regionally prevalent risk factors and associations with death in the first 28 days of life and in infancy, can be potentially impactful and could drive behavioural changes, while promoting acquisition of newer life-saving skills such as basic life support training. Such education can be considered participatory learning and action. It affords parent-carers the confidence and knowledge on measures to key risks in infancy, such as the risk of sudden infant death, and how to recognize when their baby may be ill, facilitating timely access to appropriate healthcare services. Potentially, these then empower parent-carers to work with health services proactively in measures to reduce the risks for neonatal mortality.mortality is explored, especially in less resource-constrained environments, by focusing on parent-carer education around risks for neonatal mortality, while using learning points from around the world. Potentially, these initiatives empower parent-carers to acquire the necessary skills to manage their baby at risk and also engage in risk-reducing behaviours for the benefit of their baby. Reducing neonatal mortality through parent-carer educationBefore embarking on parent education, understanding the risk factors for neonatal mortality is important. In poorly resourced areas, key risk factors and associations are infection, hypothermia, lack of breastfeeding, failure to recognise signs of illness in their baby and failure to provide adequate basic resuscitation at birth. Education packages focused on improving neonatal mortality therefore include information on maintaining warmth; drying; wrapping; skin-to-skin contact; supporting breastfeeding; infection prevention including handwashing, cord care, recognising signs of illness in their newborn baby and infant and basic life support [7].For neonatal teams in relatively higher resourced environments, where access to public health facilities and general maternal education are less of an issue, and most of the above are routinely adopted, what are other key risk factors and what other kinds of initiatives are needed in order to make a difference to current neonatal mortality rates, and can they work?In attempting to address this, the key risk factors here for neonatal mortality need to be identified. The most significant of these is prematurity [8][9][10]. In a report on perinatal mortality from MBRRACE on 2016 deaths, approximately 70% of all extended perinatal deaths occurred preterm, and almost 40% were in less than 28 weeks' gestation [9]. Optimising place of birth for the most vulnerable preterm births less than 26 weeks gestation at birth does reduce their mortality rates [11] and op...

Magnitude and Determinants of Perinatal Mortality in Southwest Ethiopia

“…Using skilled care at birth was also found to reduce perinatal mortality by about two-thirds. This finding is also in line with the findings of studies conducted in Ethiopia and other countries [ 6 , 9 , 12 – 15 ]. This can be explained by the fact that when births are attended by skilled personnel, the complications leading to stillbirth or early neonatal death, including obstructed labor, can be detected and managed or referred in a timely manner.…”

“…In this study, mothers with a previous history of perinatal mortality were more than three times more likely at risk of experiencing perinatal mortality. Previous studies also revealed similar findings [ 12 , 16 ]. This might be due to the reason that women who have repeated stillbirth or early neonatal mortality may have biological or anatomical problems related to the uterus, pelvic, or any birth canal that may lead to complications and lead to perinatal mortality.…”

Qualitative assessment of family caregiver-centered neonatal education program in Karnataka, India

“…Based on a cross sectional analysis of 13,730 families who recently delivered in three Indian states, it is clear that newborn care topics are taught within facilities, but consistency on coverage across topics differ; for example breastfeeding is mentioned the most (26.2% of participants) and dry umbilical cord care the least (0.3%) [18]. While parent and family caregiver education is promoted throughout the literature, it remains unclear the impact of this intervention on the knowledge and behaviors of trained families [19,22]. This qualitative study aims to understand how trained families experience one such neonatal education program focused on mothers and family caregivers: the neonatal Care Companion Program (CCP).…”

Just-in-time postnatal education programmes to improve newborn care practices: needs and opportunities in low-resource settings

“…These deaths could be prevented by improving families' use of practices that are shown to reduce newborn illness and death: keeping babies warm through appropriate thermal care (skin-toskin care/kangaroo mother care), early and exclusive breast feeding, infection prevention including handwashing and clean/dry umbilical cord care, and timely recognition of and care seeking for newborn illness. [4][5][6][7][8][9] Key questions ► Postnatal education for families is an important investment to improve newborn health in low/middleincome countries (LMICs), but more data are needed on families' current receipt of postnatal education and use of evidence-based newborn care practices in LMICs. ► Recent findings from a 13 000+ person survey in 3 states in India highlight opportunities for improvement in postnatal education for families and use of evidence-based newborn care practices (breast feeding, skin-to-skin care, clean/dry umbilical cord care, hand hygiene) in the home.…”