Prevention and Management of Neonatal Hypothermia in Rural Zambia

Abstract

BackgroundNeonatal hypothermia is increasingly recognized as a risk factor for newborn survival. The World Health Organization recommends maintaining a warm chain and skin-to-skin care for thermoprotection of newborn children. Since little is known about practices related to newborn hypothermia in rural Africa, this study's goal was to characterize relevant practices, attitudes, and beliefs in rural Zambia.Methods and FindingsWe conducted 14 focus group discussions with mothers and grandmothers and 31 in-depth interviews with community leaders and health officers in Lufwanyama District, a rural area in the Copperbelt Province, Zambia, enrolling a total of 171 participants. We analyzed data using domain analysis. In rural Lufwanyama, community members were aware of the danger of neonatal hypothermia. Caregivers' and health workers' knowledge of thermoprotective practices included birthplace warming, drying and wrapping of the newborn, delayed bathing, and immediate and exclusive breastfeeding. However, this warm chain was not consistently maintained in the first hours postpartum, when newborns are at greatest risk. Skin-to-skin care was not practiced in the study area. Having to assume household and agricultural labor responsibilities in the immediate postnatal period was a challenge for mothers to provide continuous thermal care to their newborns.ConclusionsUnderstanding and addressing community-based practices on hypothermia prevention and management might help improve newborn survival in resource-limited settings. Possible interventions include the implementation of skin-to-skin care in rural areas and the use of appropriate, low-cost newborn warmers to prevent hypothermia and support families in their provision of newborn thermal protection. Training family members to support mothers in the provision of thermoprotection for their newborns could facilitate these practices.

Kangaroo mother care for the prevention of neonatal hypothermia: a randomised controlled trial in term neonates

“…The warm chain includes warm delivery rooms, immediate drying, uninterrupted skin-to-skin contact as much as possible, early breast feeding, delayed bathing and weighing, appropriate bundling, mother and baby together, warm transportation, warm resuscitation, training and raising awareness 1. However, not all elements recommended in the WHO thermoregulation protocol are practised routinely in many birth facilities around the world 10. One such element is skin-to-skin contact also called kangaroo mother care (KMC).…”

Knowledge Regarding Prevention of Hypothermia Among Mothers of LBW Neonates in Sncu of M.K.C.G. Medical College Hospital

“…Zambian study had also similar results. 10 Housewife mothers (69%) had improper knowledge of baby care. 4 This study found that the mothers still need more knowledge to prevent the baby from heat loss.…”

“…9 Apart from intrinsic problems in LBW neonate, the thermal control in them is greatly influenced by knowledge and practice of caregivers specifically mother. 10,11 Objectives-To assess the level of knowledge of mothers of LBW neonates regarding prevention of hypothermia admitted in SNCU of paediatric ward of M.K.C.G. Medical College Hospital.…”

Vaginal delivery to reduce the risk of hypothermia to newborn

“…In the underdeveloped countries, it is estimated that 17 million newborns suffer from hypothermia [5,6]. The prevalence of hypothermia in Indonesia is unknown, but research in Sanglah Bali showed 47% of hypothermia in infant without any early skin to skin contact and 27% of it with early skin to skin contact [7].…”