Knowledge, attitude and practices of newborn care during the immediate postnatal period among mothers who delivered in jinja regional referral hospital, Eastern Uganda.

Abstract

Introduction and Background Neonatal mortality is a major concern all over the world, especially in developing countries including Uganda. Three quarters of all newborn deaths occur in the first week of life with nearly 50% occurring during the first 24 hours. Although research has been done in Uganda regarding newborn care practices in community setting, little is documented on newborn care practices among postnatal mothers in a hospital setting. This study therefore sought to determine the level of knowledge, attitude, practice and associated factors on newborn care among postnatal mothers in a hospital setting in order to inform policy and intervention design. Methods: This was a cross sectional study were data was collected using a structured questionnaire from 422 postnatal mothers within the first 24 hours after birth. Key Informant interviews were done to explore and understand factors associated with newborn care. Data was entered using Epi data version 3.5 and analyzed using STATA version 14. Level of knowledge was determined by proportion of postnatal mothers with correct responses. Attitude was assessed using Likert scale. While Practice was determined by the proportion of mothers who described and were able to demonstrate correctly a particular practice. Logistic regression analysis was conducted to identify factors independently associated with knowledge and practice of newborn care Results: Mothers who demonstrated adequate level of knowledge in the different categories were thermoregulation (40.1%), cord care (41.5%), breastfeeding (81.7%) and identifying danger signs (14.6%). Regarding attitude towards newborn care, 60.4% had a positive attitude towards delaying to bath the baby to keep it warm and 93.8% were in agreement that a dirty umbilical cord causes infection to the baby. In practice of newborn care,50% practiced skin to skin but only 37.6% correctly demonstrated it, 21.8% reported to have practiced cord care but only 5.4% correctly demonstrated it, in breast feeding, 92.9% reported to have practiced breastfeeding, but only 11.0% (43/392) correctly demonstrated positioning and attachment. After logistic regression, knowledge was significantly associated with a monthly income of more than 200,000Ug shillings (>52 USD) (APOR: 1.90, 95%CI: 1.07-3.366) and health education received during pregnancy (APOR: 1.97, 95%CI: 0.650-5.991). e, Practice was significantly xiii

associated with age of the mother (APOR: 2.39, 95% CI: 1.016-5.624), monthly income of more than 200,000 Uganda shillings (>52 USD) (APOR: 3.31, 95% CI: 1.794-19.109), mode of delivery (APOR: 0.26, 95% CI: 0.125-0.529) and health education received during pregnancy (APOR: 1.73, 95% CI: 0.065-2.801). Conclusions: Knowledge gaps existed regarding thermoregulation, cord care and identifying danger signs in this study population. But mothers had good knowledge on breastfeeding. There was a knowledge practice gap where mothers who reported to have carried a particular practice in the previous 24hours were not able demonstrate it.