Knowledge Attitudes and Practise of Postnantal Mothers regarding Care of the Umbilical Cord.

Abstract

Cord functions and neonatal tetanus contribute significantly to high neonatal mortality rates in developing countries. In 1992, Uganda was identified as one of the countries contributing 80% of the estimated causes of neonatal tetanus(NNT) deaths (WHO/RHT/SMS 9.994).These infections are preventable and can be reduced by practicing clean delivery, clean cord care and by avoiding harmful practices and increasing tetanus toxoid immunization coverage of women of child bearing age. OBJECTIVES This study was aimed at assessing the knowledge, attitudes, and practice of mothers regarding care of the umbilical cord. METHODS A cross-sectional descriptive study was done, using pre-tested questionnaires covering the sociodemographic, knowledge, attitudes and practice domains. An observational check list was also used. A total of 40 postnatal mothers were interviewed and observed. Data was analyzed manually. RESULTS The overall knowledge of mothers regarding cutting and tying the cord was good. T he knowledge on postnatal cord care continuity was dependant on who was caring for the cord, that was better knowledge was exhibited by the mothers who were helped by the students on domiciliary midwifery experience. There was a knowledge gap on the appropriate duration of cord care. There was also a relationship between maternal knowledge and antenatal attendance, i.e. better knowledge for mothers who attended antenatal clinic. There was a negative attitude (fear of handling the cord) by mothers, for various reasons, which hindered appropriate cord care practices. Although nearly half of the mothers (47.7%) used surgical spirit for cord care, a significant number 52.3% still applied traditional substances, which were harmful. From observation the general living conditions and home hygiene of mothers were poor. There was a gap between knowledge and practice. This disparity could be accounted for by poverty, cultural beliefs, and lack of Health Education. CONCLUSION: - Maternal knowledge regarding cord care was generally good, but some negative attitudes such as fears of handling the cord before healing and observing cultural practices of applying local substances, present a high risk factor for cord infections. This meant that these mothers’ practice regarding cord care was poor. Recommendations derived from the study were that the ministry of Health should revise the national policies and standards of cord care, strengthen Health Education on cord care at all points of contact with the mothers; increase tetanus toxoid immunization coverage of child bearing age women; Update health staff on cord care, and provide community education, information and communication on cord care.