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A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives

BACKGROUND: Ethiopia is among seven high-mortality countries which have achieved the fourth millennium development goal with over two-thirds reduction in under-five mortality rate. However, the proportion of neonatal deaths continues to rise and recent studies reported low coverage of the essential...

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Autores principales: Salasibew, Mihretab Melesse, Filteau, Suzanne, Marchant, Tanya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310200/
https://www.ncbi.nlm.nih.gov/pubmed/25495655
http://dx.doi.org/10.1186/s12884-014-0412-0
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author Salasibew, Mihretab Melesse
Filteau, Suzanne
Marchant, Tanya
author_facet Salasibew, Mihretab Melesse
Filteau, Suzanne
Marchant, Tanya
author_sort Salasibew, Mihretab Melesse
collection PubMed
description BACKGROUND: Ethiopia is among seven high-mortality countries which have achieved the fourth millennium development goal with over two-thirds reduction in under-five mortality rate. However, the proportion of neonatal deaths continues to rise and recent studies reported low coverage of the essential interventions saving newborn lives. In the context of low uptake of health facility delivery, it is relevant to explore routine practices during home deliveries and, in this study, we explored the sequence of immediate newborn care practices and associated beliefs following home deliveries in rural communities in Ethiopia. METHODS: Between April-May 2013, we conducted 26 semi-structured interviews and 2 focus group discussions with eligible mothers, as well as a key informant interview with a local expert in traditional newborn care practices in rural Basona woreda (district) near the urban town of Debrebirhan, 120 km from Addis Ababa, Ethiopia. RESULTS: The most frequently cited sequence of newborn care practices reported by mothers with home deliveries in the rural Basona woreda was to tie the cord, immediately bath then dry the newborn, practice ‘Lanka mansat’ (local traditional practice on newborns), give pre-lacteal feeding and then initiate breastfeeding. For ‘Lanka mansat’, the traditional birth attendant applies mild pressure inside the baby’s mouth on the soft palate using her index finger. This is performed believing that the baby will have ‘better voice’ and ‘speak clearly’ later in life. CONCLUSION: Coverage figures fail to tell the whole story as to why some essential interventions are not practiced and, in this study, we identified established norms or routines within the rural communities that determine the sequence of newborn care practices following home births. This might explain why some mothers delay initiation of breastfeeding and implementation of other recommended essential interventions saving newborn lives. An in-depth understanding of established routines is necessary, and community health extension workers require further training and negotiation skills in order to change the behaviour of mothers in practicing essential interventions while respecting local values and norms within the communities.
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spelling pubmed-43102002015-01-30 A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives Salasibew, Mihretab Melesse Filteau, Suzanne Marchant, Tanya BMC Pregnancy Childbirth Research Article BACKGROUND: Ethiopia is among seven high-mortality countries which have achieved the fourth millennium development goal with over two-thirds reduction in under-five mortality rate. However, the proportion of neonatal deaths continues to rise and recent studies reported low coverage of the essential interventions saving newborn lives. In the context of low uptake of health facility delivery, it is relevant to explore routine practices during home deliveries and, in this study, we explored the sequence of immediate newborn care practices and associated beliefs following home deliveries in rural communities in Ethiopia. METHODS: Between April-May 2013, we conducted 26 semi-structured interviews and 2 focus group discussions with eligible mothers, as well as a key informant interview with a local expert in traditional newborn care practices in rural Basona woreda (district) near the urban town of Debrebirhan, 120 km from Addis Ababa, Ethiopia. RESULTS: The most frequently cited sequence of newborn care practices reported by mothers with home deliveries in the rural Basona woreda was to tie the cord, immediately bath then dry the newborn, practice ‘Lanka mansat’ (local traditional practice on newborns), give pre-lacteal feeding and then initiate breastfeeding. For ‘Lanka mansat’, the traditional birth attendant applies mild pressure inside the baby’s mouth on the soft palate using her index finger. This is performed believing that the baby will have ‘better voice’ and ‘speak clearly’ later in life. CONCLUSION: Coverage figures fail to tell the whole story as to why some essential interventions are not practiced and, in this study, we identified established norms or routines within the rural communities that determine the sequence of newborn care practices following home births. This might explain why some mothers delay initiation of breastfeeding and implementation of other recommended essential interventions saving newborn lives. An in-depth understanding of established routines is necessary, and community health extension workers require further training and negotiation skills in order to change the behaviour of mothers in practicing essential interventions while respecting local values and norms within the communities. BioMed Central 2014-12-12 /pmc/articles/PMC4310200/ /pubmed/25495655 http://dx.doi.org/10.1186/s12884-014-0412-0 Text en © Salasibew et al.; licensee BioMed Central. 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Salasibew, Mihretab Melesse
Filteau, Suzanne
Marchant, Tanya
A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives
title A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives
title_full A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives
title_fullStr A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives
title_full_unstemmed A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives
title_short A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives
title_sort qualitative study exploring newborn care behaviours after home births in rural ethiopia: implications for adoption of essential interventions for saving newborn lives
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4310200/
https://www.ncbi.nlm.nih.gov/pubmed/25495655
http://dx.doi.org/10.1186/s12884-014-0412-0
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