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Habte A, Tamene A, Sewalem ZW. The receipt of health information on neonatal dangers signs during the immediate postpartum period and its determinants in Ethiopia: a multilevel mixed-effects logistic regression analysis of the 2016 Ethiopian demographic health survey report. BMC Pregnancy Childbirth 2024; 24:408. [PMID: 38844856 PMCID: PMC11154997 DOI: 10.1186/s12884-024-06605-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/24/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Identification of neonatal danger signs and immediate access to health care are two global efforts aimed at enhancing newborn and child survival by preventing 75% of neonatal deaths. Despite various small-scale studies on women's awareness of neonatal danger signs in Ethiopia, little is known about the level of receiving health information on those danger signs during the immediate postpartum period at the national level. Hence, this study aimed at assessing the level, and its determinants of the service uptake in Ethiopia. METHODS The data for this study was taken from the Ethiopian Demographic and Health Survey (EDHS), which took place from January to June 2016 and covered all administrative regions of Ethiopia. A weighted sample of 7,589.8 women was analyzed using STATA version 16. To account for data clustering, a multivariable multilevel mixed-effect logistic regression analysis was employed to determine the effects of each predictor on the outcome variable. Adjusted odds ratio with its corresponding 95% confidence interval was used to declare the statistical significance of the explanatory variables. RESULTS The receipt of health information on neonatal danger signs during the immediate postpartum period was 10.70% [95% CI:10.01, 11.40]. Variables namely living in Metropolitans [AOR = 2.06; 95%CI: 1.48, 2.88] and Large central [AOR = 1.83; 95%CI: 1.38, 2.42] regions, being in the highest wealth quintile [AOR = 1.87; 95% CI: 1.23, 2.84], being nulliparous [AOR = 0.27; 95% CI: 0.08, 0.87] and primiparous[AOR = 0.61;95% CI: 0.46, 0.79], getting adequate antenatal visits [AOR = 2.42; 95% CI: 1.75, 3.33], institutional delivery [AOR = 5.91; 95% CI: 4.66, 7.53], and receipt of postnatal visits [AOR = 3.52; 95% CI: 2.84, 4.38] were identified as significant determinants of receiving health information on newborn danger signs. CONCLUSION The findings revealed that unacceptably low uptake of health information on newborn danger signs during the immediate postpartum period in Ethiopia. A concerted effort is needed from all stakeholders in the health sector to enhance the uptake of maternal health services (antenatal care, skilled delivery service, and postnatal care). Healthcare providers should pay special attention to nulliparous and primiparous women during and after delivery, and the government should also focus on women of peripheral regions, who make up a large portion of the low coverage.
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Affiliation(s)
- Aklilu Habte
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia.
| | - Aiggan Tamene
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Ethiopia
| | - Zablon Wale Sewalem
- Department of Clinical and Psychosocial Epidemiology, University of Groningen, Groningen, Netherlands
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Wudu MA, Bekalu YE, Birehanu TA, Gebrye DB, Hailu MK. Level of knowledge about neonatal danger signs and associated factors among postpartum mothers in public hospitals, northeastern Ethiopia. Pediatr Neonatol 2024:S1875-9572(24)00041-X. [PMID: 38594168 DOI: 10.1016/j.pedneo.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/27/2023] [Accepted: 10/02/2023] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Knowing and seeking medical attention for neonatal danger signs has many benefits for reducing neonatal morbidity and death. Despite numerous interventions that have been made to raise mothers' awareness about neonatal danger signs, the desired level of knowledge has not yet been reached in Ethiopia. OBJECTIVE To assess the level of knowledge of neonatal danger signs and associated factors among postpartum mothers in public hospitals in the Eastern Amhara region, northeastern Ethiopia. METHODS A hospital-based cross-sectional study was conducted in four government hospitals between January 10, 2023, and February 10, 2023.421 participants in the study were selected using a systematic random sampling technique. Face-to-face interviews, observation, and chart reviews were used to collect the data. The association was discovered through multivariate logistic regression analysis. RESULT Only 36.6% (154) of mothers were knowledgeable about newborn danger signs in this study. Mothers who had higher institution status [(adjusted odds ratio) AOR = 3.355, 95% CI (1.751, 6.428)]; who were civil servants or a private employer [AOR = 2.986, 95% CI (1.822, 4.892)] and [AOR = 2.544, 95% CI (1.269, 5.138)]; and who had counseling about breastfeeding [AOR = 2.614, 95% CI (1.695, 4.029)] were positive predictors of awareness of neonatal danger signs. CONCLUSION In this study, the level of mothers' awareness of newborn danger signs was low and required more effort. Moreover, mothers who were educated, worked as civil servants or private employers, had a family size of 4-6, and received breastfeeding counseling were linked to mothers' good awareness of newborn danger signs. As a result, intensive community and facility-based health promotion activities on newborn danger signs should be strengthened, with special emphasis on uneducated and housewife mothers and breastfeeding counseling sessions.
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Affiliation(s)
- Muluken Amare Wudu
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia.
| | - Yemane Eshetu Bekalu
- Department of Public Health, ALKAN Health Sciences Business and Technology College, 1492, Dessie, Ethiopia
| | - Tarikua Afework Birehanu
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia
| | - Dagne Belete Gebrye
- Department of Maternity and Reproductive Health Nursing, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia
| | - Molla Kassa Hailu
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Sciences, Wollo University, 1145, Dessie, Ethiopia
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Eghrari D, Scoullar MJL, Wilson AN, Peach E, Elijah A, Melepia P, SupSup H, Vallely LM, Siba PM, Kennedy EC, Vogel JP, Homer CSE, Robinson LJ, Fowkes FJI, Pomat W, Crabb BS, Beeson JG, Morgan CJ. Low knowledge of newborn danger signs among pregnant women in Papua New Guinea and implications for health seeking behaviour in early infancy - findings from a longitudinal study. BMC Pregnancy Childbirth 2023; 23:71. [PMID: 36703135 PMCID: PMC9878757 DOI: 10.1186/s12884-022-05322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/20/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Globally, 2.5 million babies die in the first 28 days of life each year with most of these deaths occurring in low- and middle-income countries. Early recognition of newborn danger signs is important in prompting timely care seeking behaviour. Little is known about women's knowledge of newborn danger signs in Papua New Guinea. This study aims to assess this knowledge gap among a cohort of women in East New Britain Province. METHODS This study assessed knowledge of newborn danger signs (as defined by the World Health Organization) at three time points from a prospective cohort study of women in East New Britain Province, factors associated with knowledge of danger signs after childbirth were assessed using logistic regression. This study includes quantitative and qualitative interview data from 699 pregnant women enrolled at their first antenatal clinic visit, followed up after childbirth (n = 638) and again at one-month post-partum (n = 599). RESULTS Knowledge of newborn danger signs was very low. Among the 638 women, only 9.4% knew three newborn danger signs after childbirth and only one knew all four essential danger signs defined by Johns Hopkins University 'Birth Preparedness and Complication Readiness' Index. Higher knowledge scores were associated with higher gravidity, income level, partner involvement in antenatal care, and education. CONCLUSION Low levels of knowledge of newborn danger signs among pregnant women are a potential obstacle to timely care-seeking in rural Papua New Guinea. Antenatal and postnatal education, and policies that support enhanced education and decision-making powers for women and their families, are urgently needed.
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Affiliation(s)
- Donya Eghrari
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Michelle J L Scoullar
- Burnet Institute, Melbourne, Australia.
- University of Melbourne, Melbourne, Australia.
- Burnet Institute, Kokopo, Papua New Guinea.
| | - Alyce N Wilson
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | | | - Arthur Elijah
- University of Papua New Guinea, Port Moresby, Papua New Guinea
- Port Moresby General Hospital, Port Moresby, Papua New Guinea
| | | | - Hadlee SupSup
- East New Britain Provincial Health Authority, Kokopo, Papua New Guinea
| | - Lisa M Vallely
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
- The Kirby Institute, University of New South Wales, Sydney, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - Peter M Siba
- Center for Health Research and Diagnostics, Divine Word University, Madang, Papua New Guinea
| | - Elissa C Kennedy
- Burnet Institute, Melbourne, Australia
- Monash University, Melbourne, Australia
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Joshua P Vogel
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Caroline S E Homer
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
| | - Leanne J Robinson
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
- Monash University, Melbourne, Australia
| | - Freya J I Fowkes
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - William Pomat
- Papua New Guinea Institute of Medical Research, Goroka, Papua New Guinea
| | - Brendan S Crabb
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - James G Beeson
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Monash University, Melbourne, Australia
| | - Christopher J Morgan
- Burnet Institute, Melbourne, Australia
- University of Melbourne, Melbourne, Australia
- Jhpiego, a Johns Hopkins University Affiliate, Baltimore, USA
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Factors associated with reporting good maternal health-related knowledge among rural mothers of Yemen. J Biosoc Sci 2023; 55:150-168. [PMID: 34839844 DOI: 10.1017/s0021932021000663] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Increasing women's knowledge about maternal health is an important step towards empowering them and making them aware of their rights and health status, allowing them to seek appropriate health care. In Yemen, the ongoing conflict has hampered the delivery of health information to women in public health facilities. This study examined rural women's knowledge of, and attitude towards, maternal and child health in Yemen and identified the factors associated with good maternal health knowledge. The study was conducted between August and November 2018. A sample of 400 women aged 15-49 years who had delivered in the 6 months prior to the survey were systematically selected from selected public health facilities in Abyan and Lahj. Women were interviewed using a structured questionnaire to gather data on their demographic and economic characteristics, obstetric history and responses to health knowledge and attitude questions. Women's knowledge level was assessed as poor or good using the mean score as a cut-off. Chi-squared test and multiple logistic regression analysis were used to identify statistically significant factors associated with good maternal health knowledge. The percentage of women who had good knowledge was 44.8% (95% CI: 39.8-49.8). Women's attitude towards maternal health was negative in the areas of early ANC attendance, managing dietary regime and weight during pregnancy, facility delivery, PNC visits, cord care and mother and child health management. Women with primary education, whose husbands had received no formal education, who had their first ANC visit from the second trimester of pregnancy and who had fewer than four ANC visits were more likely to have poor health knowledge. Conversely, those with higher household income and only one child were more likely to have good maternal health knowledge. Overall, women's knowledge on maternal and child health care in rural areas of Yemen was low. Strategies are needed to increase rural women's knowledge on maternal and child health in this conflict-affected setting.
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Getachew T, Assebe Yadeta T, Gereziher T, Eyeberu A, Dheresa M. Determinants of maternal knowledge on neonatal danger signs and care-seeking practices in a rural area of southeastern Ethiopia. Int Health 2022; 14:610-618. [PMID: 34921316 PMCID: PMC9623491 DOI: 10.1093/inthealth/ihab084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/04/2021] [Accepted: 11/27/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Most infants in southeastern Ethiopia are either born at home or discharged from the health facility early and families should be able to recognize signs of newborn illnesses and bring the sick newborn to a health facility to receive care. However, studies are limited and the available studies were conducted in urban areas and/or at an institution level. This study aimed to assess the determinants of maternal knowledge of neonatal danger signs and care-seeking practices. METHODS A community-based cross-sectional study was conducted on 520 post-natal mothers using a multistage sampling method from 1 to 30 March 2019. The data were analysed using SPSS version 20 using binary logistic regression. Statistical significance was declared at p<0.05. RESULTS Mothers' level of knowledge of neonatal danger signs was 50.2% (95% confidence interval [CI] 46.3 to 54.3) and 61% of them sought healthcare when they noticed danger signs. Maternal education level (adjusted odds ratio [AOR] 2.15 [95% CI 1.11 to 4.17]), husband's education level (AOR 2.05 [95% CI 1.07 to 3.94]), residency (AOR 5.83 [95% CI 2.77 to 12.24]), antenatal visits (AOR 2.10 [95% CI 1.13 to 3.90]), antenatal care (ANC) counselling (AOR 4.33 [95% CI 1.88 to 9.98]) and knowledge about essential newborn care (AOR 3.91 [95% CI 2.05 to 7.48]) were the determining factors. CONCLUSION The mothers' level of knowledge of neonatal danger signs was low and unsafe care-seeking practices were identified. The mothers' education level, husbands' education level, residence, ANC visits, counselling during ANC and knowledge about essential newborn care were found to be statistically significant determinants. Most of the mothers take their sick neonates to traditional healers and provide home remedies. Intervention modalities focusing on maternal counselling on the most common symptoms of illness in neonates are essential to increase mothers' recognition of illness and improve care-seeking practices.
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Affiliation(s)
- Tamirat Getachew
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. BOX 138 Dire Dawa, Harar, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. BOX 138 Dire Dawa, Harar, Ethiopia
| | - Teklehaimanot Gereziher
- Nursing Department, College of Health Science, Aksum University, P.O. BOX 158 Aksum, Northern Ethiopia
| | - Addis Eyeberu
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. BOX 138 Dire Dawa, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, P.O. BOX 138 Dire Dawa, Harar, Ethiopia
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Zhou J, Hua W, Zheng Q, Cai Q, Zhang X, Jiang L. Knowledge about neonatal danger signs and associated factors among mothers of children aged 0-12 months in a rural county, Southwest of China: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:346. [PMID: 35448994 PMCID: PMC9026920 DOI: 10.1186/s12884-022-04592-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 03/16/2022] [Indexed: 11/17/2022] Open
Abstract
Background Delay in care seeking is one of the causes for neonatal death. Mothers’ knowledge of neonatal danger signs is imperative to promote early recognition of neonatal illness and reduce the delay in care seeking. Currently, no study has been conducted on the knowledge about neonatal danger signs in China, especially in economically less developed areas. This study aimed to examine the knowledge of neonatal danger signs and risk factors of poor knowledge among mothers in a rural county of southwest of China. Methods A cross-sectional study was conducted in Wenshan, a rural county of southwest of China. A total of 112 respondents were included from November 2020 to February 2021 among women who had babies aged 0–12 months and brought their babies to health care centers for immunization within the study period. A questionnaire with 18-item key neonatal danger signs was used to measure their knowledge about these signs. Mothers who scored above average were considered to have relatively good knowledge whereas those who scored below average were considered to have relatively poor knowledge. Independent predictors of mothers’ knowledge were identified by multivariable logistic regression analysis. Results The mean knowledge score of neonatal danger signs of mothers was 18.1 (SD = 8.6). Fifty-eight percentage of mothers (65/112) had poor knowledge of neonatal danger signs. Danger signs of “bluish or pale skin”, “chest indrawing”, and “convulsion” were mostly recognized, whereas danger signs of “not able to feed since birth, or stopped feeding well”, “excessive crying” and “eyes draining pus” were recognized poorly. Less than four antenatal visits [AOR = 4.348], younger than 25 years old [AOR = 3.839], ethnic minority [AOR = 3.956] and family financial difficulty [AOR = 4.944] were significant indicators of relatively poor knowledge. Conclusions Mothers’ knowledge about neonatal danger signs in rural China is poor even though the coverage of maternal and child health care services are expanded. Existing efforts should be enhanced for antenatal care visits, avoiding early marriage as well as early childbearing. More attention should be paid to low-income ethnic minority mothers. Educating and training should be strengthened for danger signs, especially those who are predicted to have insufficient knowledge. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04592-4.
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Affiliation(s)
- Jingxin Zhou
- Department of Neonatal Intensive Care Unit, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenzhe Hua
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Qiaomu Zheng
- Shanghai Jiao Tong University School of Nursing, Shanghai, China
| | - Qin Cai
- Children's Hospital of Shanghai Jiao Tong University, Shanghai, China
| | - Xi Zhang
- Clinical Research Unit, Xin Hua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated To Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Kebede ZT, Toni AT, Amare AT, Ayele TA, Yilma TM, Delele TG, Biks GA, Gelaye KA. Mothers experience on neonatal danger signs and associated factors in northwest Ethiopia: a community based cross-sectional study. Pan Afr Med J 2022; 41:83. [PMID: 35432706 PMCID: PMC8977360 DOI: 10.11604/pamj.2022.41.83.32176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/09/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction even though there is a significant decline in neonatal mortality globally, it remained unacceptably high in Ethiopia. The estimated experience of neonatal danger signs affects the outcome more than the perceived knowledge. The main aim of this study was to estimate the experience of mothers on neonatal danger signs and its associated factors in Northwest Ethiopia. Methods a community-based cross-sectional study was conducted from April 6-16, 2019. All the women who have delivered live birth in the past six months in three districts of Northwest Ethiopia were the source populations. A total of 2424 mothers were selected using two-stage stratified cluster random sampling technique. A pretested and semi-structured interviewer-administered questionnaire was used to collect data from eligible mothers. A multivariable logistic regression model was used to identify independent factors that affected mother´s experiences about neonatal danger signs at a p-value of 5%. Results in this study, 2335 (96.3%) mothers completed the interview and 1509 (64.6%) of them have mentioned at least one danger sign. However, only 160 (11.0%) mothers have experienced danger signs in their babies. Of these, about 54 (49.1%) mothers have noticed within 24 hours of delivery and 37 (33.6%) have noticed after 48 hours of delivery. Fifty (45.5%) mothers have noticed the danger signs at home after birth, and 48 (43.6%) have noticed during birth. The frequently reported danger signs were; baby feels hot 106 (66.3%), fast breathing 67(41.9%), and difficulty of breathing 61(38.1%). Mothers who are living in urban, AOR=1.8(95%CI: 1.04,3.0), having multiple pregnancy, AOR=9.8 (95%CI: 2.3,42.0), absence of obstetric danger signs or complication, AOR=0.4 (95%CI: 0.2,0.6), post-term gestational age, AOR=6.5 (95%CI: 2.1,19.5), preterm gestational age, AOR=3.3 (95%CI: 0.8,13.4), assessment by hospital staff during delivery, AOR=2.1 (95% CI: 1.01,4.3), and poor mothers knowledge on neonatal danger signs, AOR=0.7 (95% CI: 0.5,0.9) were the predictors of mothers experience on neonatal danger signs. Conclusion even though the knowledge of mothers on neonatal danger signs is high, the practice or experience in using their knowledge is very low. We recommend an implementation study to be conducted to bridge this "know-do" gap.
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Affiliation(s)
- Zemene Tigabu Kebede
- Departments of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia,,Corresponding author: Zemene Tigabu Kebede, Departments of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Alemayehu Teklu Toni
- Departments of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ashenafi Tazebew Amare
- Departments of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke Ayele
- Departments of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfahun Melese Yilma
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Guadu Delele
- Department of Environmental and Occupational Health, and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie Biks
- Departments of Health System and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu Gelaye
- Departments of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Habte A, Lukas K, Tamirat T. The level of Community-Based Essential Newborn Care utilization and associated factors among rural women in Southern Ethiopia, 2020: Based on the updated Community-Based Essential Newborn Care guideline. SAGE Open Med 2022; 10:20503121211067690. [PMID: 35024143 PMCID: PMC8743931 DOI: 10.1177/20503121211067690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022] Open
Abstract
Background: A Community-Based Essential Newborn Care is a national initiative that incorporates a newborn care program into the continuum of maternal and child health care through enhancing community participation to reduce child morbidity and mortality and encourage healthy growth and development. This study aimed at assessing the level of Community-Based Essential Newborn Care service uptake and its associated factors among rural women in the Guraghe zone, Southern Ethiopia, 2020. Methods: A community-based cross-sectional study was conducted in the rural districts of Southern Ethiopia, from 1 to 31 May 2020. A multistage sampling technique was applied. Using a systematic random sampling technique, a total of 818 respondents were selected. The data collected by a pretested structured questionnaire were entered into EpiData 3.1 and exported to the Statistical Package for Social Sciences (Version 23) for analysis. To identify significant predictors of Community-Based Essential Newborn Care utilization, a multivariable logistic regression analysis was fitted. Adjusted odds ratios with 95% confidence intervals were used to estimate the strength of associations, and statistical significance was declared at a p value <0.05. Results: One-third, 269 (33.1%) (95% confidence interval = 30.0–36.2), of women and their newborns got the entire packages of the Community-Based Essential Newborn Care program. Desire on the last pregnancy (adjusted odds ratio = 2.66, 95% confidence interval = 1.56–4.51), birth preparedness and complication readiness plan (adjusted odds ratio = 4.82, 95% confidence interval = 3.26–7.12), timing of the postpartum visit (adjusted odds ratio = 3,56, 95% confidence interval = 2.00–6.34), attending monthly pregnant women conference (adjusted odds ratio = 3.01, 95% confidence interval = 1.99–4.57), and being a certified model household (adjusted odds ratio = 1.88, 95% confidence interval = 1.24–2.85) were identified as key predictors of Community-Based Essential Newborn Care utilization. Conclusion: The uptake of the full Community-Based Essential Newborn Care packages in the study area was low. Health care providers at the health institution and community level should give due emphasis to improve contraceptive service delivery. Besides, health extension workers at the community level should work on providing immediate postpartum visits, creating model households, and strengthening pregnant women conferences.
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Affiliation(s)
- Aklilu Habte
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Southern Ethiopia, Ethiopia
| | - Kaleegziabher Lukas
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Southern Ethiopia, Ethiopia
| | - Temesgen Tamirat
- School of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosanna, Southern Ethiopia, Ethiopia
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Shannon C, Hurt C, Soremekun S, Edmond K, Newton S, Amenga-Etego S, Tawiah-Agyemang C, Hill Z, Manu A, Weobong B, Kirkwood B, Hurt L. Implementing effective community-based surveillance in research studies of maternal, newborn and infant outcomes in low resource settings. Emerg Themes Epidemiol 2022; 19:1. [PMID: 35022044 PMCID: PMC8756712 DOI: 10.1186/s12982-021-00109-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background Globally adopted health and development milestones have not only encouraged improvements in the health and wellbeing of women and infants worldwide, but also a better understanding of the epidemiology of key outcomes and the development of effective interventions in these vulnerable groups. Monitoring of maternal and child health outcomes for milestone tracking requires the collection of good quality data over the long term, which can be particularly challenging in poorly-resourced settings. Despite the wealth of general advice on conducting field trials, there is a lack of specific guidance on designing and implementing studies on mothers and infants. Additional considerations are required when establishing surveillance systems to capture real-time information at scale on pregnancies, pregnancy outcomes, and maternal and infant health outcomes. Main body Based on two decades of collaborative research experience between the Kintampo Health Research Centre in Ghana and the London School of Hygiene and Tropical Medicine, we propose a checklist of key items to consider when designing and implementing systems for pregnancy surveillance and the identification and classification of maternal and infant outcomes in research studies. These are summarised under four key headings: understanding your population; planning data collection cycles; enhancing routine surveillance with additional data collection methods; and designing data collection and management systems that are adaptable in real-time. Conclusion High-quality population-based research studies in low resource communities are essential to ensure continued improvement in health metrics and a reduction in inequalities in maternal and infant outcomes. We hope that the lessons learnt described in this paper will help researchers when planning and implementing their studies.
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Affiliation(s)
- Caitlin Shannon
- Impact and Innovation Team, CARE USA, 115 Broadway, 5th Floor, New York, NY, 10006, USA
| | - Chris Hurt
- Centre for Trials Research, College of Biomedical and Life Sciences, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Seyi Soremekun
- Maternal and Child Health Intervention Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Karen Edmond
- Department of Women and Children's Health, Kings College London, Strand, London, WC2R 2LS, UK
| | - Sam Newton
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Seeba Amenga-Etego
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Bono East and Bono Regions, Ghana
| | | | - Zelee Hill
- Institute for Global Health, University College London, 30 Guilford Street, London, WC1N 1EH, UK
| | - Alexander Manu
- Department of Epidemiology and Disease Control, School of Public Health, College of Health Sciences, University of Ghana, Legon, P.O. Box LG 25, Accra, Ghana
| | - Ben Weobong
- Department of Social and Behavioural Sciences, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Betty Kirkwood
- Maternal and Child Health Intervention Research Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Lisa Hurt
- Division of Population Medicine, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK.
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Gomora Tesfaye D, Dulla Koboto D, Gezahegn H. Maternal knowledge, health care seeking behaviour and associated factors for neonatal danger signs among postpartum mothers in Shashamane Town, Ethiopia: Cross sectional study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Azad R, Billah SM, Bhui BR, Ali NB, Herrera S, de Graft-Johnson J, Garg L, Priyanka SS, Zubair S, Rokonuzzaman SM, Rahman MM, Meena USJ, Arifeen SE. Mother's care-seeking behavior for neonatal danger signs from qualified providers in rural Bangladesh: A generalized structural equation modeling and mediation analysis. Front Pediatr 2022; 10:929157. [PMID: 36683813 PMCID: PMC9846223 DOI: 10.3389/fped.2022.929157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Neonatal deaths contribute to nearly half (47%) of under-five mortality globally and 67% in Bangladesh. Despite high neonatal mortality, care-seeking from qualified providers for newborn danger signs remains low. Identification of direct and indirect factors and their pathways affecting care-seeking will help to design a well-targeted intervention. This study assessed the direct, indirect, and total effect of the predictive factors on neonatal care-seeking in Bangladesh. MATERIALS AND METHODS This was a cross-sectional baseline household survey conducted in 14 districts of Bangladesh in 2019 with 17,251 recently delivered women (RDW) with a live birth outcome in the preceding 15 months. We used a two-stage stratified cluster sampling process to select the samples from 14 districts. We investigated the inter-relationship of maternal background characteristics, maternal health utilizations, child/neonate factors, health service delivery-related factors and newborn danger sign knowledge with newborn care-seeking practices and estimated the direct, indirect, and total effects using Generalized Structural Equation Modeling (GSEM) and mediation analysis. p-value = 0.05 was considered statistically significant. The result of the mediation analysis was reported in Log Odds (LOD). The positive LOD (LOD > 0) implies a positive association. RESULTS Half of the mothers (50.8%) reported a neonatal illness and among them, only 36.5% mothers of sick neonates sought care from qualified providers. Our mediation analysis showed that maternal health utilization factors, i.e., 4 + antenatal care visits (ANC) from a qualified provider (LOD: 0.63, 95% CI: 0.49, 0.78), facility delivery (LOD: 0.74, 95% CI: 0.30, 1.17) and postnatal care (PNC) from a qualified provider (LOD: 0.50, 95% CI: 0.21, 0.78) showed the highest total effect over other factors domains, and therefore, were the most important modifiable predictors for qualified neonatal care-seeking. Other important factors that directly and/or indirectly increased the chance of newborn care-seeking from qualified providers were household wealth (LOD: 0.86, 95% CI: 0.70, 1.02), maternal education (LOD: 0.48, 95% CI: 0.32, 0.63), distance to nearest health facility (LOD: 0.20, 95% CI: 0.10, 0.30), community health worker's (CHWs) home visits during ANC (LOD: 0.24, 95% CI: 0.13, 0.36), neonatal danger sign counseling after delivery (LOD: 0.20, 95% CI: 0.06, 0.34) and women's knowledge of neonatal danger signs (LOD: 0.37, 95% CI: 0.09, 0.64). CONCLUSION The inter-relationship and highest summative effect of ANC, facility delivery, and PNC on newborn care-seeking suggested the maternal care continuum altogether from ANC to facility delivery and PNC to improve care-seeking for the sick newborn. Additionally, referral training for unqualified providers, targeted intervention for poorer households, increasing CHWs home visits and neonatal danger sign counseling at the facility and community should also be considered.
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Affiliation(s)
- Rashidul Azad
- International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh
| | - Sk Masum Billah
- International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh.,The University of Sydney School of Public Health, Sydney, NSW, Australia
| | | | - Nazia Binte Ali
- International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh.,Harvard T.H. Chan School of Public Health, Boston, United States
| | | | | | - Lyndsey Garg
- Save the Children, Washington, DC, United States
| | | | | | - S M Rokonuzzaman
- International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh
| | | | | | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Bangladesh (Icddr,b), Dhaka, Bangladesh
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Kebede AA, Cherkos EA, Taye EB, Eriku GA, Taye BT, Chanie WF. Married women's decision-making autonomy in the household and maternal and neonatal healthcare utilization and associated factors in Debretabor, northwest Ethiopia. PLoS One 2021; 16:e0255021. [PMID: 34570781 PMCID: PMC8476028 DOI: 10.1371/journal.pone.0255021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 07/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Women’s decision-making autonomy is very crucial for the improvement of women empowerment, and maternal, neonatal, and child healthcare utilization. As time immemorial, Ethiopian culture is largely gender stratified, and the position of women is subordinate to men in various household and health-seeking decision-making matters. However, there is a dearth of empirical evidence on women’s decision-making autonomy, especially in the household and on maternal and newborn healthcare utilization. Therefore, this study assessed married women’s decision-making autonomy in the household and on maternal and neonatal healthcare utilization and associated factors in Debretabor, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted from October 1st to 30th, 2019. A two-stage sampling technique was used to select 730 married women. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI INFO 7 and analyzed by SPSS version 23. Multivariable logistic regression model was fitted to identify factors associated with women’s decision-making autonomy in the household and maternal and neonatal healthcare utilization. The adjusted odds ratio with its 95% confidence interval was computed to determine the level of significance at a p-value of ≤ 0.05. Results A total of 730 married women were included in the analysis. Thus, three-fourths (75.1%) of women had higher decision-making autonomy on their health, neonatal health, and other socio-economic aspects. Besides, the proportion of four and above antenatal visits, delivery at a health facility, postnatal checkup, knowledge of neonatal danger signs, and appropriate health-seeking practices for sick newborns among autonomous women were 52.1%, 56.1%, 71.4%, 32%, and 80% respectively. Age greater than 35 years old (AOR = 2.08; 95% CI: 1.19, 3.62), monthly income of > 5000 ETB (AOR = 3.1; 95% CI: 1.36, 7.07), husband involvement (AOR = 2.36; 95% CI: 1.55, 3.43), and adequate knowledge of neonatal danger signs (AOR = 2.11; 95% CI: 1.4, 3.2) were factors independently associated with women’s decision-making autonomy on maternal and neonatal healthcare utilization and other socio-economic affairs. Conclusion Our findings show that women’s decision-making autonomy in the household and maternal and neonatal healthcare utilization was optimal. Increasing household income level, promotion of husband’s involvement starting from the prenatal period, and increasing women’s knowledge of maternal and neonatal danger signs will have a great role in the improvement of women’s decision-making autonomy.
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Affiliation(s)
- Azmeraw Ambachew Kebede
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Endeshaw Admasu Cherkos
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Eden Bishaw Taye
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getachew Azeze Eriku
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhan Tsegaw Taye
- Department of Midwifery, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Wagaye Fentahun Chanie
- UNFPA Supported Maternal Health Project Coordinator, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Yitayew YA, Tadele AS, Yalew ZM, Mamuye SA, Jember DA. Knowledge of neonatal danger signs and associated factors among mothers attending pediatric immunization clinics in Gidan District Health Centers, North Wollo, Ethiopia. Heliyon 2021; 7:e07553. [PMID: 34345736 PMCID: PMC8319523 DOI: 10.1016/j.heliyon.2021.e07553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 05/15/2021] [Accepted: 07/08/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The majority of neonatal deaths in developing countries occurred at home due to late recognition of the signs of serious illness by parents or caregivers. In Ethiopia, besides the attempts made to scale-up the maternal and child health services, maternal knowledge of neonatal danger signs is low. Therefore, this study aimed to assess the knowledge of neonatal danger signs and associated factors among mothers attending pediatric immunization clinics in Gidan district health centers, North Wollo, Ethiopia. METHOD An institution-based cross-sectional study was conducted from September 1-30, 2020, among 399 mothers attending pediatric immunization clinics in Gidan district health centers. The data were collected using a pretested, structured, and interviewer-administered questionnaire. Epidata version 4.4.2.0 was used for data entry, and Statistical Package for Social Sciences version 22 was used for analysis. Descriptive statistics, bivariate and multivariate logistic regression were computed. Finally, an adjusted odds ratio along with 95% CI was calculated, and variables that had a P-value <0.05 were declared statistically significant. RESULT The level of good maternal knowledge of neonatal danger signs in the study area was 48.1% (95% CI, 43.6%-52.9%). Maternal education level (AOR: 3.58, 95% CI, 1.22-10.55), parity (AOR: 2.10, 95% CI 1.18-3.71), having postnatal care follow-up (AOR: 2.05, 95% CI, 1.21-3.49), receiving health education about neonatal danger signs (AOR: 4.87, 95% CI, 2.73-8.68), and previous experience of neonatal danger signs (AOR: 2.35, 95% CI, 1.33-4.15) were significantly associated variables with the maternal knowledge of neonatal danger signs. CONCLUSION This study revealed that maternal knowledge of neonatal danger signs was low. Maternal educational level, parity, postnatal care follow-up, health education about neonatal danger signs, and previous experience of neonatal danger signs were significantly associated variables. Therefore, maternal knowledge of neonatal danger signs needs to be enhanced through improving postnatal care services utilization and providing adequate health education about newborn health problems.
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Affiliation(s)
- Yibeltal Asmamaw Yitayew
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Zemen Mengesha Yalew
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Shiferaw Abeway Mamuye
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Desalegn Abebaw Jember
- Department of Pediatric Nursing, St. Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Kassaw MW, Abebe AM, Abate BB, Masresha SA, Kassie AM, Adisu MA. Evidence from 2016 Ethiopian demographic and health survey data: association between post health education maternal knowledge and neonatal danger signs. BMC Pregnancy Childbirth 2021; 21:195. [PMID: 33750345 PMCID: PMC7941894 DOI: 10.1186/s12884-021-03681-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 02/28/2021] [Indexed: 12/25/2022] Open
Abstract
Background Globally, 4 million infants die in their first 4weeks of life every year; above 8 million infants died before their first year of birthday, and nearly 10 million children died before their 5th birthday. Majority of the deaths were occurred at home because of not receiving health care. In Ethiopia, 120,000 infants died during their first 4 weeks of life. The aim of this study was to assess maternal knowledge about neonatal danger signs and its associations after they had been thought by health professionals in Ethiopia. Methods This study used the 2016 Ethiopian Demographic and Health Survey data (EDHS) as a data source. The 2016 EDHS data were collected using a two stage sampling method. All the regions were stratified into urban and rural areas. The study sample taken from the 2016 EDHS data and used in this further analysis was 325. A logistic regression model was used to assess the associations with post health education maternal knowledge on neonatal danger signs. Results In this study, mothers who had poor knowledge about neonatal danger signs (NDS) were 69.8 % (227) (95 %CI (64.8, 74.8 %). In the final logistic model, wanted no more child ((AOR = 4.15), (95 %CI = 1.12, 15.41)), female child ((AOR = 0.58), (95 %CI = 0.34, 0.98)), primary level maternal education ((AOR = 0.42), (95 %CI = 0.19, 0.92)), secondary level maternal education ((AOR = 0.37), (95 %CI = 0.16, 0.91)), and average size of child ((AOR = 2.64), (95 %CI = 1.26, 5.53)), and small size child ((AOR = 4.53), (95 %CI = 1.52, 13.51)) associated with post health education maternal knowledge about NDS. Conclusion The mothers’ knowledge about NDS is poor even they were gave a birth in health facilities. Wanting of additional child, child sex, maternal education and size of child were associated with NDS knowledge. This indicates that the mode of health education provided for mother might not be appropriate and needs protocol changes.
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Affiliation(s)
- Mesfin Wudu Kassaw
- Department of nursing, college of health science, Woldia University, P.O Box 400, Woldia, Ethiopia.
| | - Ayele Mamo Abebe
- Department of nursing, college of health science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Biruk Beletew Abate
- Department of nursing, college of health science, Woldia University, P.O Box 400, Woldia, Ethiopia
| | | | - Ayelign Mengesha Kassie
- Department of nursing, college of health science, Woldia University, P.O Box 400, Woldia, Ethiopia
| | - Molalign Aligaz Adisu
- Department of nursing, college of health science, Woldia University, P.O Box 400, Woldia, Ethiopia
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Berkelhamer SK, McMillan DD, Amick E, Singhal N, Bose CL. Beyond Newborn Resuscitation: Essential Care for Every Baby and Small Babies. Pediatrics 2020; 146:S112-S122. [PMID: 33004634 DOI: 10.1542/peds.2020-016915d] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2020] [Indexed: 11/24/2022] Open
Abstract
Helping Babies Breathe (HBB) addresses a major cause of newborn mortality by teaching basic steps of neonatal resuscitation and improving survival rates of infants affected by intrapartum-related events or asphyxia. Addressing the additional top causes of mortality (infection and prematurity) requires more comprehensive education, including content on thermal and nutritional support, breastfeeding, and alternative feeding strategies, as well as recognition and treatment of infection. Essential Care for Every Baby (ECEB) and Essential Care for Small Babies (ECSB) use educational principles developed with HBB as a model for teaching basic newborn care. These programs complement the content provided with HBB, further integrate counseling of families, and advance the agenda of providing quality care to all infants at birth. ECEB and ECSB have further demonstrated that engagement of individuals through active participation in their education empowers providers at all levels. With added experience teaching and implementing ECEB and ECSB, the next generation of newborn educational programs will likely incorporate bedside teaching and clinical exposure, multimedia platforms for demonstrating clinical content, and added efforts toward quality improvement. Through ECEB and ECSB, the attention brought to the newborn health agenda with HBB has only grown. Although current global health issues pose new challenges in implementing this agenda, these programs together provide a critical framework to both educate and advocate for optimal care of every newborn.
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Affiliation(s)
| | - Douglas D McMillan
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Erick Amick
- American Academy of Pediatrics, Itasca, Illinois
| | - Nalini Singhal
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; and
| | - Carl L Bose
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Kebede AA, Cherkos EA, Taye EB. Mother’s Knowledge of Neonatal Danger Signs and Health-Seeking Practices and Associated Factors in Debretabor, Northwest Ethiopia: A Community-Based Cross-Sectional Study . RESEARCH AND REPORTS IN NEONATOLOGY 2020. [DOI: 10.2147/rrn.s257768] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Knowledge of Neonatal Danger Signs and Its Associated Factors among Mothers Attending Child Vaccination Centers at Sheko District in Southwest Ethiopia. Int J Pediatr 2020; 2020:4091932. [PMID: 32547623 PMCID: PMC7273486 DOI: 10.1155/2020/4091932] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/27/2020] [Accepted: 05/07/2020] [Indexed: 12/18/2022] Open
Abstract
Background Even though a great improvement in the last twenty years, the problem of newborn deaths is still remaining. In 2017 alone, an estimated 2.5 million neonatal deaths occurred worldwide, around 39 percent of all deaths in sub-Saharan Africa. Early detection of neonatal illness is an important step towards improving newborn survival. If mothers know the appropriate manifestations of the causes of death in newborns (neonatal danger signs), it is possible to avert related mortality, because of the health-seeking behavior of mothers highly relies on their knowledge of neonatal danger signs. Objective To assess knowledge of neonatal danger signs and its associated factors among mothers attending child vaccination centers at Sheko District in Southwest Ethiopia. Methods A facility-based cross-sectional study was conducted among 351 mothers who attended health centers for child vaccination in Sheko District from March 17 to April 30, 2018. A consecutive sampling method was used to select study participants. Data were collected by using structured questionnaires through face-to-face interviews. Data were entered using EPI-DATA version 3.1 and analysed using SPSS version 21. Results Of the 351 mothers interviewed, 39% (137) had good knowledge of neonatal danger signs. The study also found that mothers aged 29-40 years (AOR = 2.37, 95% CI [1.35-4.17], P = 0.003), educational status of primary and above (AOR = 2.68, 95% CI [1.48-4.88], P = 0.001), attending ≥ 4 antenatal care visits during pregnancy (AOR = 3.57, 95% CI [2.10-6.06], P < 0.001), and history of postnatal attendance after birth (AOR = 2.33, 95% CI [1.16-4.65], P = 0.017) were significantly associated with good knowledge of neonatal danger signs. Conclusion The proportion of mothers with good knowledge of neonatal danger signs was remarkably low. Since the problem is a public health importance in developing countries, particularly in Ethiopia, which determines future generations. Great efforts are needed to create awareness for mothers on the importance of the early identifying neonatal danger signs plus to avert the high magnitude of neonatal mortality.
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Demis A, Gedefaw G, Wondmieneh A, Getie A, Alemnew B. Women's knowledge towards neonatal danger signs and its associated factors in Ethiopia: a systematic review and meta-analysis. BMC Pediatr 2020; 20:217. [PMID: 32408874 PMCID: PMC7222534 DOI: 10.1186/s12887-020-02098-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction Reducing neonatal mortality is an essential part of the third Sustainable Development Goal, to end preventable child deaths. Neonatal danger signs are the most common cause of neonatal mortality and morbidity. In Ethiopia, most babies are born at home or are discharged from the health institutions in the first 24 h, as a result enhancing women’s knowledge towards neonatal danger signs and its complication might reduce neonatal morbidity and mortality. Therefore, this systematic review and meta-analysis aimed to assess the women knowledge towards neonatal danger signs in Ethiopia. Method MEDLINE/PubMed, Scopus, Hinari, Google scholar, web of science electronic databases and grey literature from repository were searched for all the available studies. Fourteen cross sectional studies were included in this systematic review and meta-analysis. Subgroup analysis was conducted for the evidence of heterogeneity. Cochrane I2 statistics were used to check the heterogeneity of the studies. Egger test with funnel plot were used to investigate publication bias. Result Fourteen cross-sectional studies with a total of 6617 study participants were included for this study. The overall pooled prevalence of women’s knowledge towards neonatal danger sign was 40.7% (95%CI, 25.72, 55.67). Having higher educational status of the women (AOR = 3.86, 95%CI: 2.3–6.5), having higher educational status of the husband (AOR = 4.57, 95%CI: 3.29–6.35), access to mass media (AOR = 1.69, 95%CI: 1.17–2.23), having antenatal care visits (AOR = 2.63, 95%CI: 1.13–4.67), having postnatal care follow up (AOR = 2.55, 95%CI; 1.72–3.79) and giving birth at health institutions (AOR = 2.51, 95%CI:1.68–3.74) were factors associated with knowledge of the women towards danger sign of the neonate. Conclusion In this systematic review and meta-analysis the pooled prevalence of maternal knowledge towards neonatal danger sign was low. Educational status of the mother, educational status of the husband, access to mass media, antenatal care follow-up, postnatal care follow-up and place of delivery were factors associated with knowledge of the mother towards danger sign of the newborn. Promoting antenatal care, postnatal care follow-up and community-based health information dissemination about neonatal danger signs should be strengthened. Systematic review registration PROSPERO CRD42019132179.
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Affiliation(s)
- Asmamaw Demis
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box:400, Woldia, Ethiopia.
| | - Getnet Gedefaw
- Department of Midwifery, College of Health Sciences, Woldia University, P.O.Box:400, Woldia, Ethiopia
| | - Adam Wondmieneh
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box:400, Woldia, Ethiopia
| | - Addisu Getie
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box:400, Woldia, Ethiopia
| | - Birhan Alemnew
- Department of Medical Laboratory Sciences, College of Health Sciences, Woldia University, P.O.Box:400, Woldia, Ethiopia
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Bayih WA, Birhan BM, Yeshambel A, Asfaw M. Determinants of maternal knowledge of neonatal danger signs among postnatal mothers visiting neonatal intensive care unit, north Central Ethiopia, 2019: a cross-sectional study. BMC Pregnancy Childbirth 2020; 20:218. [PMID: 32295521 PMCID: PMC7160988 DOI: 10.1186/s12884-020-02896-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 03/25/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Sick neonates can be early readmitted if and only if their mothers have good knowledge of the key neonatal danger signs at first discharge. Thus, it was aimed to assess the level and determinants of maternal knowledge on these signs at first discharge from NICU. METHODS A hospital based cross sectional study design was employed at Debre Tabor General Hospital, South Gondar Zone. A sample of 363 participants was included to the study from September 2018 to February 2019 through systematic selection of every other eligible mother baby pair. Data were collected through face to face interview at time of discharge from NICU. Knowledge score of neonatal danger signs was computed by adding the total number of correct spontaneous responses to 9 key danger signs with a minimum score of 0 and maximum of 9 [0 when a mother named none of the key danger signs and 9 when the mother named all the signs]. Mothers who scored ≥3 points were considered to have good knowledge whereas those scoring less than 3 points had poor knowledge. RESULTS 224(61.70%) mothers had good knowledge of neonatal danger signs at discharge from NICU. Secondary and above level of education [AOR = 4.62], receiving danger sign information during stay at NICU [AOR = 3.64], four and above antenatal visits [AOR = 3.04], well preparedness of birth [AOR = 13.70], institutional delivery [AOR = 6.46] and good knowledge of essential newborn care [AOR = 4.41] were significant factors. CONCLUSIONS At discharge time, maternal knowledge of neonatal danger signs wasn't comparable to their exposure of NICU environment. Therefore, danger sign education should be routinely given during maternal stay at NICU. Moreover, existing efforts should be enhanced to improve number of antenatal visits, institutional delivery rate and postnatal services along the continuum of maternal and child health care in South Gondar Zone.
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Affiliation(s)
- Wubet Alebachew Bayih
- Department of Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272 Debre Tabor, Ethiopia
| | - Biniam Minuye Birhan
- Department of Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272 Debre Tabor, Ethiopia
| | - Abebaw Yeshambel
- Department of Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272 Debre Tabor, Ethiopia
| | - Molla Asfaw
- Department of Nursing, College of Health Sciences, Debre Tabor University, P.O.BOX 272 Debre Tabor, Ethiopia
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Gebreslasie S, Welu G, Berhane B, Gebresilassie B, Fseha B, Tsegay T, Negash H. Exploring knowledge on danger signs of common childhood illnesses and associated factors among mothers of under-five children in Central Tigrai, Ethiopia: a cross-sectional study. Germs 2020; 10:9-17. [PMID: 32274355 DOI: 10.18683/germs.2019.1175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/12/2019] [Accepted: 11/17/2019] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Globally, a large number of under-five deaths have occurred from preventable and treatable common childhood illnesses. Therefore, early identification of general danger signs of common childhood illnesses and adhering to appropriate treatment helps to reduce morbidity and mortality. This study aimed to assess the knowledge of mothers and associated factors on general danger signs of common childhood illnesses of under-five children in Central Tigrai, Ethiopia. METHODS A community-based cross-sectional study design was employed from February to March 2017. A total of 416 study participants were finally enrolled in the study using simple random sampling technique. A pretested and structured interviewer-based questionnaire was used. Data were entered, coded and analysed using SPSS 22.0. Multivariable logistic regression was used to control the effect of confounders. RESULTS In this study, 44.7% of the mothers had good knowledge of the general danger signs of common childhood illnesses. Mothers' educational status (AOR=1.93, 95%CI=1.09-3.44, p=0.025), occupation of mothers (AOR=5.94, 95%CI=3.17-11.12, p≤0.001), childbirth order (AOR=1.85, 95%CI=1.00-3.40, p=0.005) and source of information (AOR=2.19, 95%CI=1.23-3.87, p=0.007) were significantly associated with knowledge of mothers on general danger signs of common childhood illnesses. CONCLUSIONS Maternal knowledge of general danger signs of common childhood illnesses was low. Therefore, intervention modalities focusing on improving the educational level, behavioural change communication activities, and access of mothers to health visits are needed.
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Affiliation(s)
- Senait Gebreslasie
- MSc, Department of Midwifery, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
| | - Guesh Welu
- MSc, Department of Midwifery, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
| | - Betiel Berhane
- MSc, Department of Midwifery, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
| | - Birhanu Gebresilassie
- MSc, Department of Midwifery, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
| | - Berhane Fseha
- MSc, Department of Public Health, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
| | - Tesfay Tsegay
- MSc, Department of Nursing, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
| | - Hadush Negash
- MSc, Department of Laboratory, College of Medicine and Health Science, Adigrat University, Adigrat, Ethiopia, P.O Box 50
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Khan FA, Mullany LC, Wu LFS, Ali H, Shaikh S, Alland K, West Jr KP, Labrique AB. Predictors of neonatal mortality: development and validation of prognostic models using prospective data from rural Bangladesh. BMJ Glob Health 2020; 5:e001983. [PMID: 32133171 PMCID: PMC7042570 DOI: 10.1136/bmjgh-2019-001983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/10/2019] [Accepted: 12/10/2019] [Indexed: 12/23/2022] Open
Abstract
Objective To assess the extent to which maternal histories of newborn danger signs independently or combined with birth weight and/or gestational age (GA) can capture and/or predict postsecond day (age>48 hours) neonatal death. Methods Data from a cluster-randomised trial conducted in rural Bangladesh were split into development and validation sets. The prompted recall of danger signs and birth weight measurements were collected within 48 hours postchildbirth. Maternally recalled danger signs included cyanosis (any part of the infant's body was blue at birth), non-cephalic presentation (part other than head came out first at birth), lethargy (weak or no arm/leg movement and/or cry at birth), trouble suckling (infant unable to suckle/feed normally in the 2 days after birth or before death, collected 1-month postpartum or from verbal autopsy). Last menstrual period was collected at maternal enrolment early in pregnancy. Singleton newborns surviving 2 days past childbirth were eligible for analysis. Prognostic multivariable models were developed and internally validated. Results Recalling ≥1 sign of lethargy, cyanosis, non-cephalic presentation or trouble suckling identified postsecond day neonatal death with 65.3% sensitivity, 60.8% specificity, 2.1% positive predictive value (PPV) and 99.3% negative predictive value (NPV) in the development set. Requiring either lethargy or weight <2.5 kg identified 89.1% of deaths (at 39.7% specificity, 1.9% PPV and 99.6% NPV) while lethargy or preterm birth (<37 weeks) captured 81.0% of deaths (at 53.6% specificity, 2.3% PPV and 99.5% NPV). A simplified model (birth weight, GA, lethargy, cyanosis, non-cephalic presentation and trouble suckling) predicted death with good discrimination (validation area under the receiver-operator characteristic curve (AUC) 0.80, 95% CI 0.73 to 0.87). A further simplified model (GA, non-cephalic presentation, lethargy, trouble suckling) predicted death with moderate discrimination (validation AUC 0.74, 95% CI 0.66 to 0.81). Conclusion Maternally recalled danger signs, coupled to either birth weight or GA, can predict and capture postsecond day neonatal death with high discrimination and sensitivity.
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Affiliation(s)
- Farhad A Khan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lee F-S Wu
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Hasmot Ali
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Saijuddin Shaikh
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kelsey Alland
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Keith P West Jr
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Alain B Labrique
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Bulto GA, Fekene DB, Moti BE, Demissie GA, Daka KB. Knowledge of neonatal danger signs, care seeking practice and associated factors among postpartum mothers at public health facilities in Ambo town, Central Ethiopia. BMC Res Notes 2019; 12:549. [PMID: 31462317 PMCID: PMC6714452 DOI: 10.1186/s13104-019-4583-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/21/2019] [Indexed: 11/16/2022] Open
Abstract
Objective Neonatal mortality has remained high in Ethiopia inspite of different efforts being undertaken to reduce this negative trend. Early detection of neonatal illnesses has an important step towards improving newborn survival. Toward this end, there is a need for postpartum mothers to be able to identify signs in neonates that signifies severe neonatal illnesses. There is limited information about the knowledge of post-partum mothers on NDSs and associated factors in the study area. This study aims to assess knowledge of NDSs, care-seeking practice and associated factors among postpartum mothers in Ambo town, Ethiopia, 2018. A systematic random sampling was employed to select respondents and data was collected through face-to-face interviews. Both bivariate and multivariable logistic regressions were utilized. Results One-fifth 82 (20.3%) of postpartum mothers have good knowledge about NDSs. Only 60.5% of mothers whom their baby developed danger-sign sought medical care for their baby from health facility immediately. Mothers who have diploma/more education (AOR = 5.25, CI 1.48–18.59), whose current baby developed danger-signs (AOR = 3.18 CI 1.06–9.52), having PNC follow-up (AOR = 2.29, CI 1.24–4.24) and receiving counseling on newborn care after delivery (AOR = 1.78, CI 1.04–3.04) were factors associated with having good knowledge on NDSs. In this study the level of postpartum mother’s knowledge on NDSs and care-seeking practice were low.
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Affiliation(s)
- Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia.
| | - Daniel Belema Fekene
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Berhanu Ejara Moti
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Getu Alemu Demissie
- Department of Public Health, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Keneni Berhanu Daka
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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