Although, there have been improvement in infant survival in Tanzania, Survival rates have not met the Millennium Development Goal of reducing childhood mortality by two-thirds in 2015 from mortality rate in 2000 of the 152 per 1000. While there has been a significant decline in childhood mortality in children under 5, this decline has not translated to the neonatal population. Improvements in neonatal survival are associated with the uptake and practice of ENC. In Bahi District, Dodoma, the rate of neonatal death is 23 per 1000 live births. Little is known of the neonatal care practices in this District, and whether they are consistent with recommended ENC practices. This study therefore investigated the newborn care practices of mothers during the early neonatal period in Bahi District, Dodoma Region Central Tanzania.
Methods: This cross-sectional study recruited 461 mothers from Mundemu and Chipanga divisions, who had babies aged below 28 days. Mothers were recruited from 10 dispensaries, 2 Health Centers and General Hospital RCH clinics. Data were collected using a structured interview questionnaire, entered into Epi-Data software version 3.1 and analyzed with STATA version 11.0
Results: Approximately 50% of the mothers reported knowledge of the various components of newborn care: cord care 49%, thermal care 69%, eye care 44%, skin care 52% and breastfeeding 69%. Similarly, positive attitude towards newborn care practices among knowledgeable mothers was average: cord, thermal and skin care were 56%, 65% and 37% respectively and breastfeeding was 57%. The practice of dry cord care, whereby nothing was applied to the cord stump was practiced by 44.4% of the mothers. Rituals about securing cord drop on pubis (mapande, nyumba kaya) were reported. Cord infection was reported by 21.43% of the mothers. Optimal thermal care was reported by 52% of the mothers, whereas, 11% of mothers reported that their newborns were exposed to cold weather. Eye ointments for prophylaxis or treatment of neonatal conjunctivitis were rarely used (15.80%). Early initiation of breastfeeding was high (76%); however, prelacteal feeds (33%) and discarding of colostrum (34.63%) were reported. Age, parity, occupational and health insurance were associated with newborn care practices (p<0.05).
Conclusion: Unhealthy newborn care practices likely to affect newborn health, were reported and practiced by Rural Dodoma. Education on newborn care during the antenatal period and management of ophthalmia neonatorum has received less attention in the existing health system. Behavior change programs in the community should target both the primary audience (pregnant mothers) and secondary audience (spouse, in-laws) who are part of decision making regarding pregnancy and newborn care. Furthermore, provision of Comprehensive maternal and newborn care must be emphasized.
= Keywords: Newborn care practices, essential newborn care, early neonatal mortality.