Contextual factors influencing newborn care amongst rural poor in Western Uttar Pradesh
Vani Sethi; Sushma Kashyap; Siddharth Agarwal
Pakistan Journal of Nutrition 4(4): 273-275
2005
Document Number: 260549
A qualitative study was conducted during March-April 2004 to determine the factors influencing neonatal care in poor socially backward rural communities in Agra, Uttar Pradesh, India. 10 in-depth interviews were conducted with the mothers of neonates, and focus group discussions were performed with pregnant women, grandmothers of neonates and traditional birth attendants (TBAs). Data on birth preparedness and intra- and post-partum care were collected. Results revealed that home deliveries were common and conducted mostly by mother-in-laws (MILs) or TBAs who felt incompetent to handle complicated labour. Birth preparedness was uncommon. Nearly all neonates were left wet and naked on the floor until the placenta was delivered and bathed immediately after birth. Very few birth attendants washed their hands with soap prior to delivery, and none of them let their hands air dry after washing. Unsterilized cord tie and new blade dipped in hot water were used to tie and cut the cord. No application was applied on cord stump. Majority of the neonates were neither initiated breast feeding timely nor exclusively breast-fed. Behavioural influences were from MIL's advice, traditional beliefs or common community practices. The barriers to appropriate neonatal care were: (1) fear that if traditions were not followed the baby might be harmed; (2) families did not perceive any disadvantage of their current practice; (3) relating neonatal death to fate; and (4) low maternal self-efficacy in practicing recommended behaviours because the MIL took the final decisions regarding neonatal care. It is suggested that there is a need to engage collective dialogue with MILs and TBAs and assert the positive role they can play in promoting context responsive neonatal care.