Characteristics of Early Newborn Care: A Descriptive Analysis of Recent Births in Nigeria

BACKGROUND OR OBJECTIVES: The neonatal period, the first 28 days of life, is the most critical period for child survival. In 2017, 214,000 children in Nigeria died during the neonatal period. Newborn care practices play a key role in preventing these deaths. The aim of this study was to examine the association between delivery location and early newborn care in Nigeria. METHODS: Data from the 2013 Nigeria Demographic and Health Survey were analyzed. The main exposure variable was delivery location (home, public hospital, public health center/clinic and private hospital/clinic). The outcomes were early initiation of breastfeeding, breastfeeding support, and cord examination. We used multivariate logistic regression to estimate the odds of newborn care. RESULTS: We observed that the prevalence of all three outcome indicators was low. After adjusting for confounders, birth in public health facilities, compared to home birth, was associated with early initiation of breastfeeding (public hospitals: OR 1.62, 95% CI: 1.29-2.03; public health centers/clinics OR: 1.28, 95% CI: 1.02-1.61). Breastfeeding support and cord examination were each associated with birth in public hospitals only compared to home birth (OR 1.41, 95% CI: 1.09-1.81 and OR 1.41, 95% CI: 1.11-1.79, respectively). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Early newborn care in Nigeria was suboptimal and the quality of this care varied across delivery locations and birth attendants. Public hospitals had the most favorable newborn care outcomes. Policies and programs to enhance the quality of facility-based early newborn care and promote community-based newborn care could improve neonatal outcomes and reduce overall child mortality in resource-challenged settings.