Service-Related Factors Associated With Newborn Care Practices by Mothers in Mutare, Zimbabwe: A Cross-Sectional Study

Abstract

Neonatal mortality remains very high in Zimbabwe (29/1,000 live births). Service-related factors have been linked to the care-giver knowledge and newborn care practices. In Manicaland Province, care-seeking behaviors for fever (the main symptom for childhood infections) and knowledge levels of neonatal danger signs remains unacceptably lower than the national averages. A cross-sectional descriptive and analytic design was carried out to determine service-related factors to newborn care practices and their association with neonatal outcomes in Mutare District. Purposive sampling was used to select health facilities and systematic random sampling was used to select participants. A structured interviewer administered questionnaire was used to collect data which was then entered and analyzed using Epi-Info version 7.2. Descriptive and multivariate analysis were performed on data collected from 349 participants. Practice of the five assessed recommended newborn care practices was high. Exclusive breastfeeding (62%), early initiation of breastfeeding (74%), good cord care (73%), care-seeking for neonatal illness within 24hrs of onset of fever (82%) and keeping baby warm was at 58%. Statistically significant independent factors associated with the recommended newborn care practices were post-natal stay for more than 72 hours at the clinic (AOR=0.56; 95%CI: 0.12-0.87, p=0.000), and delivery at the health facility (AOR=0.43; 95%CI: 0.21-0.77; p=0.000). Service delivery had a substantial influence on newborn care practices in Mutare district and influenced neonatal outcomes. Improving newborn care outcomes requires both effective service delivery and community health system strengthening to promote good newborn care.

Medical Pluralism and Cultural Practices Associated with Umbilical Cord-Care in Rural Communities in Zimbabwe

“…In Zimbabwe, studies indicate that neonatal mortality has been on the rise. The neonatal mortality rate increased from 20 deaths per 1,000 live births in 2004 to 29.5 deaths per 1,000 live births in 2019 (Zimbabwe National Statistics Agency & ICF International, 2016;Chiwawa et al, 2020;Knoema, 2021). The rising rate of neonatal mortality in Zimbabwe has been ascribed to various factors, including limited access to healthcare facilities, poor quality of treatment received during postpartum care and the interferences of harmful cultural practices in newborn and postpartum care.…”

“…In Zimbabwe, the survival of the neonate has been largely dependent on the quality of care available during pregnancy, delivery and the postpartum period, either at health facilities or in the community (Bhutta et al, 2009;Chiwawa et al, 2020). As a result, the Ministry of Health and Child Care (MoHCC) has stated that the mother and family must understand aspects of childbirth and newborn care as well as be prepared to manage the potential dangers such as umbilicus-related infections (MoHCC, 2020).…”

“…As a result, the Ministry of Health and Child Care (MoHCC) has stated that the mother and family must understand aspects of childbirth and newborn care as well as be prepared to manage the potential dangers such as umbilicus-related infections (MoHCC, 2020). These levels of interaction between mothers of the newborn child and various care providers during the most critical time of a newborn baby's life are of significant concern since more than 50% of infant mortalities occur in the first month of life (Chiwawa et al, 2020). For the newborn, the WHO recommends clean and dry umbilical cord care, or in low-income countries where neonatal mortality is high, applying chlorhexidine gel/solution to the umbilical cord stump is recommended (WHO, 2022).…”