Home Neonatal Care Practices During the First Week of Life in Selected Upper Egyptian Governorates
Ayman A.E. El-Mohandes, Reginald Gipson, Lamiaa Mohsen, Esmat Mansour, Mohamed H. Hussein. Prevention and Community Health, George Washington University-School of Public Health and Health Services, Washington, DC; John Snow Inc., Cairo, Egypt; Pediatric Department, Cairo University, Cairo, Egypt; Ministry of Health and Population, Cairo, Egypt; Public Health Department, Cairo University, Cairo, Egypt.
BACKGROUND: Neonatal care home practices in Egypt, during the first week of life, are largely unreported. More than 60% of births and 80% of neonatal deaths continue to occur in the home environment. An important strategy for improving child survival is the reduction of neonatal mortality through improving home infant care, emphasizing preventative measures and early recognition of danger signs.
OBJECTIVE: Identify the providers of care for newborns in the first week of life. Describing common neonatal care practices, and substandard and harmful practices.
DESIGN/METHODS: Home visits were made to 217 recently delivered mothers in selected rural areas of Fayoum, Luxor and Aswan governorates. Villages were selected based on the presence of trained community workers (ra'idat) who were able to identify the recently delivered women and conduct proper interviews.
RESULTS: Prompt initial feeding, feeding of colostrum, and most bathing practices were in accordance with agreed upon standards for neonatal care. A number of deficits and potentially harmful practices were identified. Lack of hand-washing before neonatal care was reported in 50% of cases. Supplementation of breast milk occured in half of the newborns at the first feeding. Lack of exclusive breastfeeding was reported for 1/5 of neonates. Lack of antiseptic application to the umbilical cord stump of one half of neonates, and the potentially harmful practices of applying Kohl to the cord of one-tenth of neonates also were of concern.
CONCLUSIONS: This study is the most comprehensive report on neonatal care practices in Egypt to date. Some care activities were in accordance with agreed-upon standards of care. A number of deficits in practice were identified, however, some of which were particularly problematic in certain governorates. Moreover, mothers reported some practices that are potentially harmful. Training of home care providers, whether mothers or others, on proper neonatal care is recommeded. Health education during antenatal care visits and enforcement of timely postpartum home visits may be the appropriate venue.
PAS 2005: 57: 2414
Tuesday, May 17, 2005 11:30 am, Washington Convention Center - Room 207 A
Platform Session: Global Perspectives on Birth Asphyxia, Part II (10:30 AM - 12:30 PM)
Course Number: 7350