Cross sectional, community based study of care of newborn infants in Nepal
Osrin, D.; Tumbahangphe, K.M.; Shrestha, D.; Mesko, N.; Shrestha, B.P.; Manandhar, M.K.; Standing, H.; Manandhar, D.S.; Costello, A.M.de.L.
BMJ 325(7372): 1063
2002
ISSN/ISBN: 0959-8138 PMID: 12424164 DOI: 10.1136/bmj.325.7372.1063Document Number: 244150
Objective: To determine home-based newborn care practices in rural Nepal that will improve neonatal outcome. Design: Cross-sectional, retrospective study using structured interviews (September 1999-June 2000). Setting: Makwanpur district, Nepal. Participants: 5411 married women aged 15 to 49 years who had given birth to a live baby in the past year. Main outcome measures: Attendance at delivery, hygiene, thermal care, and early feeding practices. Results: 4893 (90%) women gave birth at home. Attendance at delivery by skilled government health workers was low (334, 6%), as was attendance by traditional birth attendants (267, 5%). Only 461 (8%) women had used a clean home delivery kit, and about half of attendants had washed their hands. Only 3482 (64%) newborn infants had been wrapped within half an hour of birth, and 4992 (92%) had been bathed within the first hour. Ninety-nine percent (5362) of babies were breast fed, 91% (4939) within six hours of birth. Practices with respect to colostrum and prelacteals were not a cause for anxiety. Conclusions: Health promotion interventions most likely to improve newborn health in this setting include increasing attendance at delivery by skilled service providers, improving information for families about basic perinatal care, promotion of clean delivery practices, early cord cutting and wrapping of the baby, and avoidance of early bathing.