Background New-born survival is a prominent goal on the global health agenda and an important area of focus for programs seeking to ensure child survival. Geographically, neonatal deaths are most prevalent in Sub-Saharan Africa and southern Asia, accounting for 39% and 38% of all neonatal deaths respectively while Ethiopia in particular has 28% neonatal death. Promotion of essential new-born care practice is one of a cheap approach to improve health outcomes of new-born babies. Thus, this study was aimed to assess the magnitude of essential newborn care practices and associated factors among postnatal mothers in Nekemte city, Western Ethiopia. Methods An institution-based cross-sectional study was conducted from February to March, 2017, in Nekemte city, East Wollega Zone. Data was collected from 417 randomly selected mothers who have less than six months infants by face to face interview in three public health institutions of Nekemte City, Ethiopia. Women who were not biological mother to the new-born were excluded from the study. The collected data were coded, cleaned and entered using Epi-Data version 3.1 and analysed using Statistical Package for Social Science (SPSS) version 21.0. Both bivariable and multivariable logistic regression analysis were computed to identify associated factors. The strength of association was measured by odds ratios with 95% confidence interval (CI) at a p-value of < 0.05 and finally obtained results were presented by using simple frequency tables, graphs, and charts. Results The study revealed that the level of essential new-born care practice was 184(44.1%). The overall safe cord care practice of the respondents was 285 (68.3%) while the optimal thermal care practices and good neonatal feeding were 328 (78.7%) and 322 (77.2%) respectively. Having visit to Antenatal Care (ANC) [Adjusted Odds Ratio (AOR) = 4.38, 95% CI = (1.38, 13.94)], knowledge of essential new-born care [AOR = 4.58, 95% CI = (2.93, 7.16)], and counselled about essential new-born care [AOR = 2.32, 95% CI = (1.38, 3.91)] were factors significantly associated with good practices of essential new-born care. Conclusion This study indicated that the level of essential new-born care practice was unsatisfactory in the study area. Promotion of essential new-born care through the provision of community awareness and provision of counselling on essential new-born care and neonatal danger signs to all pregnant women should be given emphasis.
An institution-based cross-sectional study was conducted in Nekemte city public health facilities from February to March 2017. Nekemte city is located in the Western part of the Oromia region at 331 km away from country’s capital, Addis Ababa. The city has four public health institutions, namely Nekemte referral hospital, Wollega University referral hospital (started to function after data collection), Nekemte health centre, and Cheleleki health centres each giving health care service to the population of the town and nearby populations. According to Central Statistics Agency Branch in the town in 2016, the total population of the town is projected to be 97,289 among which young people in the town is estimated to be 37,796 (Male = 19,626, Female = 18,170) [21]. A total of 417 mothers with an infant aged less than six months were included in the study. The sample size was computed using a single population proportion formula considering 52.1% proportion of timely breastfeeding initiation in four regions of Ethiopia [15], 95% confidence level, 5% marginal error, and 10% nonresponse rate, the final sample size was 422. Systematic random sampling was used to select the study participants from the three public health facilities in Nekemte city namely; Nekemte referral hospital (NRH), Nekemte health centre (NHC) and Cheleleki health centre (CHC). The previous 3 months' clients flow to the three health facilities for Maternal and Child Health (MCH) service was reviewed from the registration book to estimate the expected number of mothers that visited the clinic in a month. Therefore, the average number of mothers visited the clinic in the previous three months back was 492, 243, and 135 for NRH, NHC, and CHC respectively. The calculated sample size (422) was allocated to each health facility based on proportion to the population size of the 3 health facilities. Accordingly, proportional allocation to population size for each health facility was 239, 118 and 65 to Nekemte referral hospital, Nekemte health centre and Cheleleki health centre respectively. Sampling interval (k) was determined by dividing the total number of mothers expected to visit the MCH clinic of each health facility within a month by the number of sample size allocated to each health facility, thus sampling interval was approximately 2 for each health facility. Postnatal women paired to their infants who came to health facility during data collection period within six month of their delivery were included while those wo were not biological mother to the new-born were excluded from the study. A semi-structured pretested interviewer-administered questionnaire was used. The tool was developed after exhaustively reviewing different relevant kinds of literature [14, 17–19]. The questionnaire comprises socioeconomic characteristics, information on health service utilization, mothers’ knowledge on new-born care and neonatal danger signs. The tool was prepared in the English version and it was translated into the regional working language, Afaan Oromo, and again translated back to the English language to check the consistency. The translated Afaan Oromo version questionnaire was used for data collection after pre-test in similar areas outside of the study site on 5% of the sample size before the actual data collection. The reliability of the questionnaire was checked by computing the cronbach’s alpha. Multicollinearity test was also done and reported by Variance inflation factor (VIF) which was 1.02. Three data collectors and two supervisors were recruited from outside selected facilities. The purpose of the study was explained to them to minimize bias during data collection. The data collectors were trained for one day on basic principles of data collection, and how to gather information using interview. Furthermore, training on data completeness, cross-checking and corrective actions were given to the supervisors. The data were compiled, cleaned and entered at the end of each data collection day. Essential new-born care: is a care provided to every new-born baby by postnatal mothers, which composed of neonatal feeding, cord care and thermal care. Essential new-born care practice: The practice was reported ‘good’ for mothers who practiced three components (safe cord care, optimal thermal care, and good neonatal feeding) appropriately while the practice was reported ‘poor’ if at least one component was missed from three components [17–20]. Safe cord care: Defined as keeping the cord, clean and dry without application of any substance on the cord stump except medically indicated medications like chlorhexidine [17, 18]. Optimum thermal care: A new-born wrapped in clean and dry cloth and delay bathing a new-born delivery for 24 hours to prevent hypothermia [17, 18]. Neonatal feeding: Defined as initiating breastfeeding within the first one hour after birth, giving no pre-lacteal and feeding the child with colostrum [17, 18]. Knowledge of essential new-born care: Knowledge was ‘good’ for mothers who responded greater than 50% of knowledge related questions correctly whereas knowledge was ‘poor’ for mothers who responded less than or equal to 50% of knowledge related questions [17,18]. Knowledge of new-born danger sign- those mothers who identified at least 4 among the six listed danger signs categorized as good knowledge on neonatal danger sign and for those who mentioned less than four of danger signs were categorized as poor knowledge on neonatal danger sign. The collected data were entered into Epi data Version 3.1 and were analysed using SPSS version 20. Bivariate logistic regression analysis was used to see the significance of the association between dependent and independent variables. A P-Value of less than 0.05 was taken as statistically significant. Multivariable logistic regressions were used to identify associated factors & the strength of association was measured by odds ratios with 95% CI. Variables that had a significant association with the outcome variables in the crude analysis at p-value less than 0.2 were entered into the multivariable logistic regression model. In a Multivariable logistic regression model using adjusted odds ratio (AOR) independent predictors of new-born care practices among postpartum mothers were identified through controlling the confounding effects of other variables. Descriptive statistics were calculated and finally obtained results were presented by using simple frequency tables, graphs, and charts. Prior to data collection, ethical approval was obtained from ethical review committee of Addis Ababa University, school of Allied health sciences, department of Nursing and Midwifery with a reference number of 348/MSc/91/09. Official letter of permission was also obtained from the Oromia regional health bureau and Guto Gida district health bureau. Letter of cooperation from Guto Gida district health bureau was brought to the selected health facilities to get access to study participants. Respondents were told the aim of the study and informed written consent was obtained from the mothers before starting the interview.
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