Assessing Household Practices that Influence Neonatal Survival in the Asante-Akim North District of Ashanti Region - Ghana

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Improved neonatal survival depends on the provision of health care from antenatal, intranatal and postnatal periods. The type of care received during delivery is often critical for the health and survival of both newborn baby and mother. Although reductions in maternal and child mortalities by 2015 are two of the MDGs, and in spite of governments’ efforts and that of other agencies to achieve this goal, maternal as well as neonatal mortalities still remain high. The study was carried out to identify the socio-economic factors and delivery care practices in newborn care, care takers’ ability to recognize and manage newborn danger signs, and to explore the traditional practices influencing newborn care in the Asante-Akim North District. It was a community-based non-interventional study conducted over a three-month period, in which questionnaires were administered to 370 randomly selected freshly delivered mothers and 10 Traditional Birth Attendants. Findings indicated low socio-economic status. Ninety percent of respondents attested to the fact that clean child birth practices such as, hand-washing, washing of perineum (by 84 percent of respondents), and delivery on a covered surface prevailed. However, 62 percent of respondents had their babies bathed immediately after delivery. Some cord care practices such as using thread to tie the cord by community-based health care providers, TBAs and relatives prevailed, and in most cases, it is not known whether the thread used is clean. Application of substances such as wood ash, salt, tomato juice, ointment (sold to mothers by health staff) in the two major health facilities, and ground cocoyam on the cord stump were recorded. Though 86 percent of mothers gave breast milk as first feed to their newborn babies, breast feeding was mostly initiated within one hour after birth (by 68 percent of respondents). Hygiene was not adequately ensured during breastfeeding among a significant number (36 percent) of mothers, and they did not see the need to do so. However, breastfeeding on-demand was practiced by only 38 percent respondents. Seven percent of mothers bathed the newborn babies with herbal preparations and traditional soaps in order to prevent them from falling sick and contracting a disease traditionally known as ‘Asram’. Knowledge on some newborn danger signs such as high body temperature, diarrhoea and excessive crying were common but more serious danger signs such as jaundice, twitching etc were not known. Ninety-one percent of respondents would take their babies to the hospital upon recognition of the danger signs mentioned. There is the need to train all health care providers, and educate mothers more on current essential newborn care practices. Community-based mother support groups should be established at the community level.