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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2016

Open Access 01-12-2016 | Research article

Factors associated with adoption of beneficial newborn care practices in rural Eastern Uganda: a cross-sectional study

Authors: Michael O. Owor, Joseph K. B. Matovu, Daniel Murokora, Rhoda K. Wanyenze, Peter Waiswa

Published in: BMC Pregnancy and Childbirth | Issue 1/2016

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Abstract

Background

Beneficial newborn care practices can improve newborn survival. However, little is known about the factors that affect adoption of these practices.

Methods

Cross-sectional study conducted among 1,616 mothers who had delivered in the past year in two health sub-districts (Luuka and Buyende) in Eastern Uganda. Data collection took place between November and December 2011. Data were collected on socio-demographic and economic characteristics, antenatal care visits, skilled delivery attendance, parity, distance to health facility and early newborn care knowledge and practices. Descriptive statistics were computed to determine the proportion of mothers who adopted beneficial newborn care practices (optimal thermal care; good feeding practices; weighing and immunizing the baby immediately after birth; and good cord care) during the neonatal period. We conducted multivariable logistic regression to assess the covariates of adoption of all beneficial newborn care practices. Analysis was done using STATA statistical software, version 12.1.

Results

Of the 1,616 mothers enrolled, 622 (38.5 %) were aged 25-34; 1,472 (91.1 %) were married; 1,096 (67.8 %) had primary education; while 1,357 (84 %) were laborers or peasants. Utilization of all beneficial newborn care practices was 11.7 %; lower in Luuka (9.4 %, n = 797) than in Buyende health sub-district (13.9 %, n = 819; p = 0.005). Good cord care (83.6 % in Luuka; 95 % in Buyende) and immunization of newborn (80.7 % in Luuka; 82.5 % in Buyende) were the most prevalent newborn care practices reported by mothers. At the multivariable analysis, number of ANC visits (3-4 vs. 1-2: Adjusted (Adj.) Odds Ratio (OR) = 1.69, 95 % CI = 1.13, 2.52), skilled delivery (Adj. OR = 2.66, 95 % CI = 1.92, 3.69), socio-economic status (middle vs. low: Adj. OR = 1.57, 95 % CI = 1.09, 2.26) were positively associated with adoption of all beneficial newborn care practices among mothers.

Conclusion

Adoption of all beneficial newborn care practices was low, although associated with higher ANC visits; middle-level socio-economic status and skilled delivery attendance. These findings suggest a need for interventions to improve quality ANC and skilled delivery attendance as well as targeting of women with low and high socio-economic status with newborn care health educational messages, improved work conditions for breastfeeding, and supportive policies at national level for uptake of newborn care practices.
Literature
1.
Lawn JE, Cousens S, Zupan J. 4 million neonatal deaths: when? Where? Why? Lancet. 2005;365(9462):891–900.CrossRefPubMed
2.
Wang H, Liddell CA, Coates MM, Mooney MD, Levitz CE, Schumacher AE, Apfel H, Iannarone M, Phillips B, Lofgren KT, et al. Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384(9947):957–79.CrossRefPubMedPubMedCentral
3.
Waiswa P, Peterson S, Tomson G, Pariyo GW. Poor newborn care practices - a population based survey in eastern Uganda. BMC Pregnancy Childbirth. 2010;10:9.CrossRefPubMedPubMedCentral
4.
Black RE, Levin C, Walker N, Chou D, Liu L, Temmerman M. Reproductive, maternal, newborn, and child health: key messages from Disease Control Priorities 3rd Edition. Lancet. 2016.
5.
Lawn JE, Kinney M, Lee AC, Chopra M, Donnay F, Paul VK, Bhutta ZA, Bateman M, Darmstadt GL. Reducing intrapartum-related deaths and disability: can the health system deliver? International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2009;107(Suppl 1):S123-140, s140–122.CrossRef
6.
Simon W, Kirsten M, Lara B, Sarah J, Louise H, Wickremasinghe R, Renton A. Ending newborn deaths: Ensuring every baby survives. London: Save the Children; 2014.
7.
Young M, Wolfheim C, Marsh DR, Hammamy D. World Health Organization/United Nations Children's Fund Joint Statement on Integrated Community Case Management: An Equity-Focused Strategy to Improve Access to Essential Treatment Services for Children. Am J Trop Med Hyg. 2012;87(5 Suppl):6–10.CrossRefPubMedPubMedCentral
8.
UNICEF. Committing to child survival: A promise renewed progress report 2013. New York: UNICEF; 2013.
9.
Bryce J, Daelmans B, Dwivedi A, Fauveau V, Lawn JE, Mason E, Newby H, Shankar A, Starrs A, Wardlaw T: Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking coverage of interventions. Lancet. 2008;371(9620):1247–58.
10.
Imdad A, Bautista RM, Senen KA, Uy ME, Mantaring JB, Bhutta 3rd ZA. Umbilical cord antiseptics for preventing sepsis and death among newborns. Cochrane Database Syst Rev. 2013;5:Cd008635.
11.
Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, Sankar MJ, Blencowe H, Rizvi A, Chou VB, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? Lancet. 2014;384(9940):347–70.CrossRefPubMed
12.
Darmstadt GL, Kumar V, Yadav R, Singh V, Singh P, Mohanty S, Baqui AH, Bharti N, Gupta S, Misra RP. Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India. J Perinatol. 2006;26(10):597–604.CrossRefPubMed
13.
Lawn JE, Mwansa-Kambafwile J, Horta BL, Barros FC, Cousens S. Kangaroo mother care’ to prevent neonatal deaths due to preterm birth complications. Int J Epidemiol. 2010;39 Suppl 1:i144–54.CrossRefPubMedPubMedCentral
14.
Haroon S, Das JK, Salam RA, Imdad A, Bhutta ZA. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;13 Suppl 3:S20.CrossRefPubMedPubMedCentral
15.
Imdad A, Yakoob MY, Bhutta ZA. Effect of breastfeeding promotion interventions on breastfeeding rates, with special focus on developing countries. BMC Public Health. 2011;11 Suppl 3:S24.CrossRefPubMedPubMedCentral
16.
Darmstadt GL, Walker N, Lawn JE, Bhutta ZA, Haws RA, Cousens S. Saving newborn lives in Asia and Africa: cost and impact of phased scale-up of interventions within the continuum of care. Health Policy Plan. 2008;23(2):101–17.CrossRefPubMed
17.
Gabrysch S, Lema C, Bedrinana E, Bautista MA, Malca R, Campbell OM, Miranda JJ. Cultural adaptation of birthing services in rural Ayacucho, Peru. Bull World Health Organ. 2009;87(9):724–9.CrossRefPubMed
18.
Varma DS, Khan ME, Hazra A. Increasing postnatal care of mothers and newborns including follow-up cord care and thermal care in rural Uttar Pradesh. J Fam Welf. 2010;56(Special Issue):31–41.
19.
Blencowe H, Cousens S, Kamb M, Berman S, Lawn JE. Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality. BMC Public Health. 2011;11 Suppl 3:S9.CrossRefPubMedPubMedCentral
20.
Waiswa P, Kemigisa M, Kiguli J, Naikoba S, Pariyo GW, Peterson S. Acceptability of evidence-based neonatal care practices in rural Uganda - implications for programming. BMC Pregnancy Childbirth. 2008;8:21.CrossRefPubMedPubMedCentral
21.
Homer CSE, Friberg IK, Dias MAB, ten Hoope-Bender P, Sandall J, Speciale AM, Bartlett LA. The projected effect of scaling up midwifery. Lancet. 2014;384(9948):1146–57.CrossRefPubMed
22.
Ten Hoope-Bender P, de Bernis L, Campbell J, Downe S, Fauveau V, Fogstad H, Homer CSE, Kennedy HP, Matthews Z, McFadden A. Improvement of maternal and newborn health through midwifery. Lancet. 2014;384(9949):1226–35.CrossRefPubMed
23.
Ayiasi M, Van Royen K, Verstraeten R, Atuyambe L, Criel B, Garimoi C, Kolsteren P. Exploring the focus of prenatal information offered to pregnant mothers regarding newborn care in rural Uganda. BMC Pregnancy Childbirth. 2013;13(1):176.CrossRefPubMedPubMedCentral
24.
MOH. Situation analysis of newborn health in Uganda: Current status and opportunities to improve care and survival. Kampala: Government of Uganda. Save the Children, UNICEF, WHO; 2008.
25.
Dickson KE, Simen-Kapeu A, Kinney MV, Huicho L, Vesel L, Lackritz E, et al. Every Newborn: health-systems bottlenecks and strategies to accelerate scale-up in countries. Lancet. 2014;384(9941):438–54.
26.
Lawn JE, Tinker A, Munjanja SP, Cousens S. Where is maternal and child health now? Lancet. 2006;368(9546):1474–7.CrossRefPubMed
27.
Darmstadt GL, Oot DA, Lawn JE. Newborn survival: changing the trajectory over the next decade. Health Policy Plan. 2012;27 Suppl 3:iii1–5.CrossRefPubMed
28.
Darmstadt GL, Kinney MV, Chopra M, Cousens S, Kak L, Paul VK, Martines J, Bhutta ZA, Lawn JE. Who has been caring for the baby? Lancet. 2014;384(9938):174–88.CrossRefPubMed
29.
Mason E, McDougall L, Lawn JE, Gupta A, Claeson M, Pillay Y, et al. From evidence to action to deliver a healthy start for the next generation. Lancet. 2014;384(9941):455–67.CrossRefPubMed
30.
Ten Hoope-Bender P, Renfrew MJ. Midwifery - a vital path to quality maternal and newborn care: the story of the Lancet Series on Midwifery. Midwifery. 2014;30(11):1105–6.CrossRefPubMed
31.
Rosato M, Laverack G, Grabman LH, Tripathy P, Nair N, Mwansambo C, Azad K, Morrison J, Bhutta Z, Perry H, et al. Community participation: lessons for maternal, newborn, and child health. Lancet. 2008;372(9642):962–71.CrossRefPubMed
32.
Schiffman J, Darmstadt GL, Agarwal S, Baqui AH. Community-based intervention packages for improving perinatal health in developing countries: a review of the evidence. Semin Perinatol. 2010;34(6):462–76.CrossRefPubMed
33.
Waiswa P, Peterson SS, Namazzi G, Ekirapa EK, Naikoba S, Byaruhanga R, Kiguli J, Kallander K, Tagoola A, Nakakeeto M, et al. The Uganda Newborn Study (UNEST): an effectiveness study on improving newborn health and survival in rural Uganda through a community-based intervention linked to health facilities - study protocol for a cluster randomized controlled trial. Trials. 2012;13:213.CrossRefPubMedPubMedCentral
34.
Children S. Every newborn, every mother, every adolescent girl. Lancet. 2014;383(9919):755.CrossRef
35.
Bhutta ZA, Chopra M, Axelson H, Berman P, Boerma T, Bryce J, Bustreo F, Cavagnero E, Cometto G, Daelmans B, et al. Countdown to 2015 decade report (2000-10): taking stock of maternal, newborn, and child survival. Lancet. 2010;375(9730):2032–44.CrossRefPubMed
36.
Lawn JE, Blencowe H, Oza S, You D, Lee AC, Waiswa P, et al. Every newborn: progress, priorities, and potential beyond survival. Lancet. 2014;384(9938):189–205.
37.
New K, Konstantopoulos A, Arulkumaran S, Day-Stirk F. Every newborn: the professional organisations’ perspective. Lancet. 2014;384(9938):e25–6.CrossRefPubMed
38.
UBOS. Uganda demographic and health survey 2011. Kampala: UBOS and Calverton, Maryland: ICF International Inc; 2011.
39.
Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297–334.CrossRef
40.
Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006;21(6):459–68.CrossRefPubMed
41.
Nyamtema A, Jong A, Urassa D, Hagen J, van Roosmalen J. The quality of antenatal care in rural Tanzania: what is behind the number of visits? BMC Pregnancy Childbirth. 2012;12(1):70.CrossRefPubMedPubMedCentral
42.
43.
Conrad P, Schmid G, Tientrebeogo J, Moses A, Kirenga S, Neuhann F, Muller O, Sarker M. Compliance with focused antenatal care services: do health workers in rural Burkina Faso, Uganda and Tanzania perform all ANC procedures? Trop Med Int Health. 2012;17(3):300–7.PubMed
44.
Tann C, Kizza M, Morison L, Mabey D, Muwanga M, Grosskurth H, Elliott A. Use of antenatal services and delivery care in Entebbe, Uganda: a community survey. BMC Pregnancy Childbirth. 2007;7:23.PubMed
45.
Tetui M, Ekirapa EK, Bua J, Mutebi A, Tweheyo R, Waiswa P. Quality of Antenatal care services in eastern Uganda: implications for interventions. Pan Afr Med J. 2012;13:27.PubMedPubMedCentral
46.
Kadobera D, Sartorius B, Masanja H, Mathew A, Waiswa P. The effect of distance to formal health facility on childhood mortality in rural Tanzania, 2005-2007. Glob Health Action. 2012;5:1–9.PubMed
47.
Joshi C, Torvaldsen S, Hodgson R, Hayen A. Factors associated with the use and quality of antenatal care in Nepal: a population-based study using the demographic and health survey data. BMC Pregnancy Childbirth. 2014;14(1):94.CrossRefPubMedPubMedCentral
48.
Byaruhanga R, Nsungwa-Sabiiti J, Kiguli J, Balyeku A, Nsabagasani X, Stefan P. Hurdles and opportunities for newborn care in rural Uganda. Midwifery. 2011;6(27):775–80.CrossRef
49.
Shah BD, Dwivedi LK. Newborn care practices: A case study of tribal women, Gujarat. Health. 2013;5:29–40.CrossRef
50.
Newbrander W, Natiq K, Shahim S, Hamid N, Skena NB. Barriers to appropriate care for mothers and infants during the perinatal period in rural Afghanistan: A qualitative assessment. Glob Public Health. 2013;9(sup1):S93–109.CrossRefPubMedPubMedCentral
51.
Fenn B, Kirkwood BR, Popatia Z, Bradley DJ. Inequities in neonatal survival interventions: evidence from national surveys. Arch Dis Child Fetal Neonatal Ed. 2007;92(5):F361–6.CrossRefPubMedPubMedCentral
52.
Baqui A, El-Arifeen S, Darmstadt G, Ahmed S, Williams E, Seraji H, Mannan I, Rahman S, Shah R, Saha S. Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet district, Bangladesh: a cluster-randomised controlled trial. Lancet. 2008;371(9628):1936–44.CrossRefPubMed
53.
Johnston ML, Esposito N. Barriers and facilitators for breastfeeding among working women in the United States. J Obstet Gynecol Neonatal Nurs. 2007;36(1):9–20.CrossRefPubMed
54.
Stewart-Glenn J. Knowledge, perceptions, and attitudes of managers, coworkers, and employed breastfeeding mothers. AAOHN J. 2008;56(10):423–9. quiz 430-421.CrossRefPubMed
55.
Ukegbu AU, Ebenebe EU, Ukegbu PO, Onyeonoro UU. Determinants of breastfeeding pattern among nursing mothers in Anambra State, Nigeria. East Afr J Public Health. 2011;8(3):226–31.PubMed
56.
Balogun OO, Dagvadorj A, Anigo KM, Ota E, Sasaki S. Factors influencing breastfeeding exclusivity during the first 6 months of life in developing countries: a quantitative and qualitative systematic review. Matern Child Nutr. 2015;11(4):433–51.CrossRefPubMed
57.
Huffman SL. Determinants of breastfeeding in developing countries: overview and policy implications. Stud Fam Plan. 1984;15(4):170–83.CrossRef
58.
Adelaja LM. A survey of home delivery and newborn care practices among women in a suburban area of Western Nigeria. ISRN Obstet Gynecol. 2011;2011:9.CrossRef
59.
Devkota MD, Bhatta MR. Newborn Care Practices of Mothers in a Rural Community in Baitadi, Nepal. Health Prospect. 2012;10:5.
60.
Waldenström U. Women’s memory of childbirth at two months and one year after the birth. Birth. 2003;30(4):248–54.CrossRefPubMed
61.
Waldenström U, Schytt E. A longitudinal study of women’s memory of labour pain—from 2 months to 5 years after the birth. BJOG. 2009;116(4):577–83.CrossRefPubMed
62.
Stanton CK, Rawlins B, Drake M, dos Anjos M, Cantor D, Chongo L, Chavane L, da Luz Vaz M, Ricca J. Measuring Coverage in MNCH: Testing the Validity of Women's Self-Report of Key Maternal and Newborn Health Interventions during the Peripartum Period in Mozambique. PloS one. 2013;8(5):e60694.CrossRefPubMedPubMedCentral
63.
Gupta S, Yamada G, Mpembeni R, Frumence G, Callaghan-Koru JA, Stevenson R, Brandes N, Baqui AH. Factors associated with four or more antenatal care visits and its decline among pregnant women in Tanzania between 1999 and 2010. PLoS One. 2014;9(7):e101893.CrossRefPubMedPubMedCentral
64.
Magadi MA, Madise NJ, Rodrigues RN. Frequency and timing of antenatal care in Kenya: explaining the variations between women of different communities. Soc Sci Med. 2000;51(4):551–61.CrossRefPubMed
65.
Osorio AM, Tovar LM, Rathmann K. Individual and local level factors and antenatal care use in Colombia: a multilevel analysis. Cad Saude Publica. 2014;30:1079–92.CrossRefPubMed
Metadata
Title
Factors associated with adoption of beneficial newborn care practices in rural Eastern Uganda: a cross-sectional study
Authors
Michael O. Owor
Joseph K. B. Matovu
Daniel Murokora
Rhoda K. Wanyenze
Peter Waiswa
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2016
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-016-0874-3

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