Assessment of Level of Knowledge and Practice of Essential Newborn Care and its Determinants Among Recently Delivered Women in Ficthe Town, North Shewa Zone, Oromia Region, Ethiopia
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Date
2015-06
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Addis Ababa University
Abstract
Background- Neonatal mortality contributes a higher percentage to infant mortality rates (IMR)
especially in developing countries including Ethiopia where the rate of institutional, skill assisted
delivery is low and the fact that the absence of emergency neonatal support service contribute to
the problem. Therefore, it is justified to the level of mothers’ knowledge and practice of the
Essential Newborn Care is timely.
Objective: The aim of this study is to assess the level of knowledge & practice and factors
associated with Essential Newborn Care among Recently Delivered Women (RDW), in Fitche
town, Oromia Region.
Methods: A community based cross-sectional study was conducted from February to March, 2015
in Fitche Town using a mixed survey method (both quantitative as well as qualitative).Quantitative
data was collected from the sampled 389 women who delivered in previous 12 months of the date
of the data collection in Fitche town. The survey participants were identified using a stratified
random sampling technique. Structured and pretested questionnaire was used to obtain information
about the knowledge and practice of Essential Newborn Care. The quantitative data were
supplemented by information obtained from key informant using in-depth interview method. The
sample size for the qualitative method was determined by saturation of idea. The quantitative data
was first entered in to EPI-Info version 3.1 and exported to SPSS statistical packages version 21.
Descriptive summary measures and association between the various background variables and
knowledge and practice were done. Binary and multivariate logistic regression study analysis was
done to identify factors associated with dependent variables. Thematic analysis was used for the
qualitative study
Result: A total of 386 women participated in the quantitative survey. The majority of women
261(67.6%) were in the age 20-29 years. 117(30.3%) women were illiterate. The majority
367(95.1%) of women made at least one antenatal care (ANC) visit during their last pregnancy.
Majority of the respondents 339(87.8%) delivered in the health facility. Only few 67(17.4%)
women reported receiving a postnatal check by a health worker or health extension workers in the
first week after delivery. Less than half 179 (46.4%) of the mothers’ had good overall knowledge
about ENC. Knowledge was rated highest with immediately and exclusive breast feeding and
lowest was rated with danger signs identification, eye care and immunization. Women who were
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illiterate [AOR: 0.153, (95% CI: 0.052-0.445)], able to read & write, [AOR (95%CI)
0.162(0.027-0.989)], and also women who received grade 9-10 education, [AOR (95%CI)
0.372(0.141-0.982)], Those women whose household monthly income was from 1401-2350
ETB,[AOR: 0.311, (95% CI: (0.113-0.858)] and Women who registered for ANC sixteen weeks
and above of gestation, [AOR: 0.535, (95% CI: 0.311-0.921)], were found significant predictors
on level of knowledge about ENC. Regarding to practices, greater than half 214 (55.4%) of
mothers’ had good overall practices about ENC. Practice was rated highest with immediately and
exclusive breast feeding and lowest rated with thermal care especially immediate placement of the
newborn. Women who had poor knowledge of ENC, [AOR: 0.158, (95% CI: 0.085-0.293)],
women who were in the age group fifteen to nineteen, [AOR: 142.7, (95% CI: 5.249-3880)], and
women who didn’t have counseling at antenatal, [AOR: 0.492, (95% CI: 0.245-0.987)], were
found significant predictors on level of practice about ENC.
The in- depth interview identified that: giving food and fluid immediate after birth up to 6 months
& bottle feeding, bathing immediate after birth, use of unsterile and unclean material for cutting
and tying umbilical cord, application of substance on cord stump and not giving colostrum or first
milk for the newborn causes infection to the newborn. Concerning practices, respondents
confirmed that there are cultural practices exercised in the community on the application of
substances on cord stump, prelactant feeding, bathed immediately after birth using cold water
especial for home delivery causes infection to the newborn.
Conclusion and recommendation
Among the recently delivered mothers, 207(53.4%) had poor knowledge about Essential Newborn
Care and from the components of ENC; mothers were most knowledgeable on breast feeding.
Knowledge gaps exist with regard to eye care, immunization and danger signs identification in
neonate. Maternal education programs should be given emphasis for the components of ENC for
mothers’ knowledge gaps. Maternal education must be giving due attention for Women who were
illiterate, able to read & write and also women who received grade 9-10 education, mothers whose
household monthly income was from 1401-2350 ETB, Women who registered for ANC sixteen
weeks and above of gestation and mothers who had poor knowledge about ENC
Description
Keywords
Essential Newborn Care