Local understandings of care during delivery and postnatal period to inform home based package of newborn care interventions in rural Ethiopia

BACKGROUND: Despite a substantial decrease in child mortality in Ethiopia over the past decade, neonatal mortality remains unchanged (37/1000 live-births). This paper describes a qualitative study on beliefs and practices on immediate newborn and postnatal care in four rural communities of Ethiopia conducted to inform development of a package of community-based interventions targeting newborns. METHODS: The study team conducted eight key informant interviews (KII) with grandmothers, 27 in-depth interviews (IDI) with mothers; seven IDI with traditional birth attendants (TBA) and 15IDI with fathers, from four purposively selected communities located in Sidama Zone of Southern Nationalities, Nations, and Peoples (SNNP) Region and in East Shewa and West Arsi Zones of Oromia Region. RESULTS: In the study communities deliveries occurred at home. After cutting the umbilical cord, the baby is put to the side of the mother, not uncommonly with no cloth covering. This is largely due to attendants focusing on delivery of the placenta which is reinforced by the belief that the placenta is the 'house' or 'blanket' of the baby and that any "harm" caused to the placenta will transfer to the newborn. Applying butter or ointment to the cord "to speed drying" is common practice. Initiation of breastfeeding is often delayed and women commonly report discarding colostrum before initiating breastfeeding. Sub-optimal breastfeeding practices continue, due to perceived inadequate maternal nutrition and breast milk often leading to the provision of herbal drinks. Poor thermal care is also demonstrated through lack of continued skin-to-skin contact, exposure of newborns to smoke, frequent bathing-often with cold water baths for low-birth weight or small babies; and, poor hygienic practices are reported, particularly hand washing prior to contact with the newborn. CONCLUSION: Cultural beliefs and newborn care practices do not conform to recommended standards. Local perspectives related to newborn care practices should inform behaviour change messages. Such messages should target mothers, grandmothers, TBAs, other female family members and fathers

Environmental health · Family medicine · Psychological intervention · Public health · Qualitative research · Social science · Sociology · Breastfeeding Practices and Influences · Child Nutrition and Water Access · Global Maternal and Child Health · Medicine · Nursing · Gerontology

• Generally the young mom suffers much

  Open Access•Scott B Ickes, Grace Heymsfield et al.•Maternal and Child Nutrition•2016

  Incluir item

• Postnatal care utilization and local understandings of contagion among HIV-infected and uninfected women in rural, southern Zambia

  Emma Sacks, William J Moss et al.•AIDS Care•2016

  Incluir item

• Barriers to the utilization of community-based child and newborn health services in Ethiopia

  Open Access•Nathan P Miller, Farid Bagheri Ardestani et al.•Health Policy and Planning•2021

  Incluir item

• Continuum of care for maternal, newborn, and child health

  Open Access•Kate Kerber, Kate J Kerber et al.•The Lancet•2007

  Incluir item

• Evidence-based, cost-effective interventions

  Open Access•Gary L Darmstadt, Zulfiqar A Bhutta et al.•The Lancet•2005

  Incluir item

• Effect of home-based neonatal care and management of sepsis on neonatal mortality

  Open Access•Abhay T Bang, Abhay Bang et al.•The Lancet•1999

  Incluir item

• Global, regional, and national causes of child mortality

  Open Access•Li Liu, Hope L Johnson et al.•The Lancet•2012

  Incluir item

• Maternal mortality

  Open Access•Carine Ronsmans, Warren Graham et al.•The Lancet•2006

  Incluir item

• Community-Based Interventions for Improving Perinatal and Neonatal Health Outcomes in Developing Countries

  Zulfiqar A Bhutta, Gary L Darmstadt et al.•PEDIATRICS•2005

  Incluir item

• Strategies for reducing maternal mortality

  Open Access•Oona M R Campbell, Oona MR Campbell et al.•The Lancet•2006

  Incluir item

• Effect of a participatory intervention with women's groups on birth outcomes in Nepal

  Open Access•D S Manandhar, David Osrin et al.•The Lancet•2004

  Incluir item

• WHO estimates of the causes of death in children

  Open Access•Jennifer Bryce, Cynthia Boschi-Pinto et al.•The Lancet•2005

  Incluir item

• Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet district, Bangladesh

  Open Access•Abdulla H Baqui, Abdullah H Baqui et al.•The Lancet•2008

  Incluir item

• Newborn survival

  Open Access•Gary L Darmstadt, D A Oot et al.•Health Policy and Planning•2012

  Incluir item