https://imcjms.com Ibrahim Medical College Journal of Medical Science https://imcjms.com/registration/journal_full_text/183 Tue, 11 Apr 2017 16:29:17 +0000 Reducing maternal and neonatal mortality remains a big challenge for a developing country like Bangladesh. Mothers’ knowledge in neonatal care plays an important role in bringing down the mortality as well as morbidity. This study was conducted in Dhaka Shishu Hospital during the period of December 2007 to February 2008 and was based on primary data collected on socioeconomic status, knowledge and practice of mothers of neonates attending the hospital. A total of 400 mothers were interviewed. More than fifty percent mothers had an appropriate knowledge on feeding neonates, hand washing before handling neonates, care of eye, care of umbilicus and they were practicing as well. Where as less than fifty percent mothers had appropriate knowledge on keeping neonates warm, cutting hair, bathing, vaccination, oil massage and their practice rate also commensurate well with their knowledge level. Majority of the mothers were in the age group of 21-25 years, having completed primary education or passed SSC exam. They were house wives living in an urban area, with a monthly family income of 3000-7000 taka. Statistically significant association was found between socio demographic variables and knowledge and practices on neonatal care of the mothers. Address for Correspondence: Housne Ara Begum, Assistant Professor, Institute of Health Economics, University of Dhaka, Dhaka-1000, Bangladesh, Phone: 088 02 9661920-50 Ex-8649 (Off), email:drhousne@gmail.com   Neonatal mortality contributes to almost two thirds of infant deaths in Bangladesh. Infection, prenatal asphyxia, premature birth and low-birth are identified as major causes of neonatal mortality. These deaths can only be seriously addressed if there is informed demand for and provision of quality promotive, preventive and curative neonatal care services.1 Skilled professional care during pregnancy, at birth and during the postnatal period is as critical for the newborn baby as it is for its mother. The challenge is to find a better way of establishing continuity between care during pregnancy, at birth, and when the mother is at home with her baby. While the weakest link in the care chain is skilled attendance at birth, care during the early weeks of life is also problematic because professional and programmatic responsibilities are often not clearly delineated.2   This was a cross-sectional study among the mothers of the neonates attending Dhaka Shishu Hospital during the period of December 2007 to February 2008. Sampling was purposive and only willing mothers were interviewed. The sample size was determined by using the following formula for cross sectional study: n = Z2 (p x q) / d2 where n= required sample size, Z = the standard normal deviate/ distribution 1.96 at 95% confidence level /interval. p=0.5; q= (1-p) = (1- .5) = 0.5; d = (error), degree of accepted allowable sampling error was 0.05 (5%) in this study. Based on this calculation the estimated sample size was 384. Data collection tool was a combination of structured type of questionnaire which was tested in the OPD and IPD of Dhaka Shishu Hospital. To find out the level of knowledge and practice appropriate answer was given score 1 and inappropriate answer was given score 0. Then they were computed and recoded and grouped in three categories; excellent (7-9), optimum (5-6), poor (0-4). Results     Table 2 shows that only 5.8% mothers had excellent knowledge on neonatal care, 55.3% mothers had optimum knowledge, and 39% mothers had poor knowledge.The level of practice of the respondent mothers on neonatal care observed that only 5.5% mothers performed excellently where as 71.8% mother performed poorly, only 22.8% mother performed optimally. 10.5% of the respondent mothers started breast feeding within 6hrs, 10.5% of the respondent mothers gave colostrum, 95.5% of the respondent’s mothers exclusively breast fed for 6 months where as 4.3% of the respondent mothers did not feed colostrum. Table-2: Level of knowledge of respondent mothers on neonatal care (n=400)   There was significant association between knowledge and practice on care of the umbilicus, cutting hair, hand washing, massage oil, feeding (Tables not shown). The nature of association between knowledge and practice among the above mentioned variables need further study. But there were no significant associations between vaccinations of neonates, bathing the neonates, and care of the eyes of neonates. Discussion Although 90.8% of the respondents replied that hand washing was essential before handling a neonate, 51.8% of them admitted doing so. A 1 year prospective study on routine gowning before entering a neonatal unit was conducted in a maternity hospital in Singapore. The investigators recommend that routine gowning before entering a neonatal unit is not essential and cost effective for the purpose of reducing infection. Rather the focus should be on adequate hand washing by all hospital personnel and visitors before handling neonates.6 During a study of pregnancy in a poor rural tropical area, a high prevalence of neonatal fever and umbilical cord infection was detected. Interim analysis showed that this was associated with subsequent development of neonatal sepsis The study demonstrates the importance of umbilical cord care in the etiology of life threatening neonatal morbidity in village births in a developing country and the effect of a simple intervention in reducing morbid episodes in the neonate.7 As unhygienic newborn-care practices lead to continued high risk for omphalitis, in addition to topical antiseptics, simple, low-cost interventions such as hand washing, skin-to-skin contact, and avoiding unclean cord applications should be promoted by community-based health workers.8 Present study found a statistically significant association between education of mother and shaving hair, hand washing, umbilical care, bathing, massage oil, vaccination, and proper eye care. Mothers had a fair knowledge regarding need for immunization but a poor knowledge regarding the diseases prevented and doses of the vaccines. Health workers were the major source of information and 76% knew the use and maintenance of immunization cards.9 About 88% of the respondent agreed to consult a doctor for any kind of eye problem. But 11.8% applied kajol, 5.8% used homeopaths drugs, 2.5% applied oil, 13.5 applied breast milk. Mothers got information on neonatal care mainly from relatives/ guardians, books/TV, posters, which played a very insignificant role. There was significant association between occupation of mother and umbilical care, bathing and eye care. Residenceof parentsandbathingandeyecarealsohad a statistically significant association. Income of parents and shaving hair and bathing had also been associated. Conclusion   1.   Save the Children, USA. Newborn Care Practices in Rural Bangladesh. Save the Children Federation, 2003; VII. 3.   Essential newborn care 1996 WHO/FRH/MSM/96.13. 5.   Christensson K, Ransjö-Arvidson AB, Kakoma C, Lungu F, Darkwah G, Chikamata D and Sterky G. Midwifery Care Routines and Prevention of Heat Loss in the Newborn. A Study in Zambia. Journal of Tropical Pediatrics 1988; 34(5): 208-212. 7.   Paul G, Lai D, Manasseh B, Edwards K and Heywood P. Avoiding Neonatal Death: An Intervention Study of Umbilical Cord Care. Journal of Tropical Pediatrics 1994; 40(1): 24-28. 9.   Singh MC, Badole CM, Singh MP. Immunization coverage and the knowledge and practice of mothers regarding immunization in rural area. Indian J Public Health 1994; 38(3): 103-7. 11.LC Mullany, G L Darmstadt, SK Khatry and JM Tielsch. Traditional Massage of Newborns in Nepal: Implications for Trials of Improved Practice. Journal of Tropical Pediatrics 2005; 51(2): 82-86. 2026 Ibrahim Medical College. All rights reserved.