Knowledge of postnatal mothers on essential newborn care practices at the Kenyatta national Hospital: A cross sectional study

  • Pan African Medical Journal, Volume 28, Year 2017

listen audio

Study Justification:
– The study aims to assess maternal knowledge on essential newborn care practices at Kenyatta National Hospital.
– The neonatal mortality rate in Kenya is currently higher than the Sustainable Development Goal target, making it important to identify areas for improvement.
– By understanding the knowledge gaps, interventions can be developed to improve newborn care practices and reduce neonatal mortality.
Study Highlights:
– The study found that mothers had good knowledge on breastfeeding practices, but there were knowledge gaps regarding cord care, eye care, and immunization.
– Factors associated with poor knowledge included lack of education on newborn care during pregnancy and incomplete or no antenatal visits.
– The study highlights the importance of targeting mothers who do not fully attend antenatal clinics for newborn care education.
Study Recommendations:
– Develop educational programs on cord care, eye care, and immunization to address the knowledge gaps identified.
– Ensure that all mothers receive education on newborn care during pregnancy, regardless of their attendance at antenatal clinics.
– Strengthen antenatal care services to provide comprehensive education on essential newborn care practices.
Key Role Players:
– Healthcare providers: They play a crucial role in providing education and counseling to postnatal mothers on essential newborn care practices.
– Policy makers: They can develop policies and guidelines to improve newborn care practices and ensure their implementation.
– Community health workers: They can help disseminate information and provide support to mothers in the community.
Cost Items for Planning Recommendations:
– Development of educational materials: This includes the cost of designing and printing materials such as brochures, posters, and pamphlets.
– Training of healthcare providers: This includes the cost of organizing training sessions and workshops for healthcare providers on essential newborn care practices.
– Awareness campaigns: This includes the cost of organizing community outreach programs and awareness campaigns to disseminate information on newborn care practices.
– Monitoring and evaluation: This includes the cost of monitoring and evaluating the implementation and impact of the interventions to ensure their effectiveness.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study design is a hospital-based cross-sectional study, which provides valuable information on maternal knowledge of essential newborn care practices. The sample size of 380 postnatal mothers is relatively large, increasing the generalizability of the findings. The study also used structured pretested questionnaires for data collection and conducted statistical analysis using SPSS. However, there are some limitations to consider. The study only focused on postnatal mothers in Kenyatta National Hospital, which may limit the generalizability of the findings to other settings. Additionally, the study relied on self-reported knowledge, which may be subject to recall bias. To improve the strength of the evidence, future studies could consider using a larger and more diverse sample, including both urban and rural populations. It would also be beneficial to validate the self-reported knowledge with objective measures, such as observation or medical records.

Introduction: Of the 130 million babies born yearly, nearly 4 million die in the neonatal period. Kenya Demographic Health Survey (KDHS) 2014 places neonatal mortality rate at 22 deaths per 1,000 live births, well above the Sustainable Development Goal (SDG) 3 that aims to reduce these mortalities to at least 12 deaths per 1000 live births by 2030. The aim of the study was to assess maternal knowledge on selected components of essential newborn care: breastfeeding, cord care, immunisation, eye care and thermoregulation. Methods: A hospital based cross-sectional study was conducted on 380 postnatal mothers in Kenyatta National Hospital. Interviews were conducted using structured pretested questionnaires. A score of one was given for correct response and zero for incorrect. Data were analysed using SPSS version 18. Results: Modes of thermoregulation identified included kangaroo care (7%), warm room (4%) and warm clothing (93%). Almost all mothers knew of breastfeeding on demand, exclusive breastfeeding and colostrum use. Only 17.8% of mothers identified Bacillus Calmette-Guérin (BCG) and Oral Polio Vaccine (OPV) were birth vaccines. Only 4 mothers knew no substances should be applied to the cord. In logistic regression, factors significantly associated with poor knowledge included lack of education on newborn care during pregnancy, incomplete (less than 3) or no antenatal visits with an odds ratio (OR) of 3.3 (95% confidence interval (CI), 1.5 to 7.4), 2.5(1.5 to 4.2), 5.1(1.3 to 19.3) and p values of 0.003, 0.001 and 0.018 respectively. Conclusion: Knowledge gaps existed regarding cord care, eye care, and immunization. Mothers had good knowledge on breastfeeding practices. Those who fail to fully attend antenatal clinics should be targeted for newborn care education.

Study design: A hospital based cross-sectional study was carried out in Kenyatta national Hospital (KNH) postnatal wards between July 2013 and September 2013. Study population: A total of 380 postnatal mothers were selected using consecutive sampling. Postnatal mothers of neonates born in the hospital who gave informed consent were included in the study. Exclusion criteria consisted of mothers whose neonates died or were admitted to nursery immediately after birth and those with significant congenital anomalies. Study procedure: Participants were interviewed on the day of discharge using structured pretested questionnaires that captured data on socio-demographic characteristics, antenatal and perinatal history and knowledge towards essential newborn care practices. Data collection: The data collection was carried out by the principal investigator or the research assistant. After recruiting the study subjects, a structured pre-tested questionnaire was used to collect data. The questionnaire was administered to the mother and their responses filled in. The questionnaire consisted of both close and open ended questions addressing the following: neonate’s and parents socio-demographic data; antenatal and birth history of the neonate; mother’s knowledge on the WHO essential newborn care practices. Knowledge was assessed by closed ended and open ended questions. Data analysis and management: Data were collected and stored in the Microsoft access database. The collected data were then coded, verified and analysed using the statistical package for social sciences computer version 18.0 software. A scoring system was used to analyse responses to closed ended questions on knowledge: 1 = Correct response (consistent with WHO essential newborn care guidelines); 0 = Incorrect response (inconsistent with WHO essential newborn care guidelines). Any mother who did not know the answer was considered to have an incorrect response. The responses for the open ended questions were summarized and descriptive statistics carried out. During analysis for factors associated with poor maternal knowledge on newborn care, the median score was used as a cut off to distinguish between poor knowledge and satisfactory knowledge. A total of 16 questions were asked to assess knowledge on various aspects of newborn care. Those scoring below the median were considered to have poor knowledge and above or equal to the median considered satisfactory knowledge. The level of knowledge was then cross tabulated against the variables of interest. The variables which were significantly associated with poor knowledge at bivariate analysis were further analysed using multivariate analysis test (multiple logistic regression) to determine factors independently associated with poor knowledge. Associations between poor knowledge and each independent variable were examined by odds ratios (OR) and 95% Confidence Interval. Statistical testing was done using Chi square tests to compare dependent variables with explanatory variables. Data were then presented using pie charts, histograms and tables.

N/A

Based on the description provided, here are some potential innovations that can be used to improve access to maternal health:

1. Mobile Health (mHealth) Applications: Develop mobile applications that provide educational resources and information on essential newborn care practices. These apps can be easily accessible to postnatal mothers, providing them with accurate and up-to-date knowledge.

2. Telemedicine: Implement telemedicine services to connect postnatal mothers with healthcare professionals remotely. This allows mothers to receive guidance and support on essential newborn care practices without the need for physical visits to healthcare facilities.

3. Community Health Workers: Train and deploy community health workers to provide education and support to postnatal mothers in their homes. These workers can visit mothers regularly, addressing any knowledge gaps and providing guidance on essential newborn care practices.

4. Text Messaging Services: Establish text messaging services that send automated reminders and educational messages to postnatal mothers. These messages can cover topics such as breastfeeding, cord care, immunization, and thermoregulation, helping to reinforce knowledge and promote healthy practices.

5. Collaborative Partnerships: Foster collaborations between healthcare facilities, non-profit organizations, and community-based organizations to create comprehensive maternal health programs. These partnerships can ensure that postnatal mothers receive holistic support, including education, access to healthcare services, and community resources.

6. Online Support Groups: Develop online platforms or forums where postnatal mothers can connect with each other and healthcare professionals to share experiences, ask questions, and receive support. This can help create a sense of community and provide a space for ongoing learning and knowledge exchange.

It is important to note that the specific implementation of these innovations would require further planning, research, and consideration of local context and resources.
AI Innovations Description
Based on the description provided, the study identified several knowledge gaps among postnatal mothers regarding essential newborn care practices such as cord care, eye care, and immunization. The study also found that mothers who did not receive education on newborn care during pregnancy and those who had incomplete or no antenatal visits were more likely to have poor knowledge.

To improve access to maternal health and address these knowledge gaps, the following recommendations can be considered:

1. Strengthen antenatal care: Emphasize the importance of attending antenatal visits and ensure that comprehensive education on essential newborn care practices is provided during these visits. This can include information on breastfeeding, cord care, immunization, eye care, and thermoregulation.

2. Develop targeted education programs: Identify mothers who have not fully attended antenatal clinics and specifically target them for newborn care education. This can be done through individual counseling sessions, group education sessions, or community-based programs. The education should focus on addressing the specific knowledge gaps identified in the study.

3. Enhance healthcare provider training: Provide training to healthcare providers, including doctors, nurses, and midwives, on effective communication and counseling skills related to essential newborn care practices. This will enable them to effectively educate and support mothers in adopting these practices.

4. Utilize technology and media: Leverage technology and media platforms to disseminate information on essential newborn care practices. This can include the use of mobile phone applications, text messaging services, radio programs, and television campaigns to reach a wider audience and reinforce key messages.

5. Engage community health workers: Involve community health workers in educating and supporting mothers in essential newborn care practices. Community health workers can play a crucial role in reaching remote or marginalized populations and providing ongoing support and guidance.

6. Establish support groups: Create support groups for postnatal mothers where they can share experiences, receive guidance, and learn from each other. These groups can be facilitated by healthcare providers or community organizations and can provide a platform for mothers to discuss challenges and receive practical advice.

By implementing these recommendations, access to maternal health can be improved, and mothers can be empowered with the knowledge and skills necessary to provide optimal care for their newborns.
AI Innovations Methodology
In order to improve access to maternal health, there are several potential recommendations that can be considered:

1. Increase awareness and education: Implement programs to educate pregnant women and their families about essential newborn care practices, including breastfeeding, cord care, immunization, eye care, and thermoregulation. This can be done through antenatal clinics, community health workers, and mass media campaigns.

2. Strengthen antenatal care services: Ensure that all pregnant women have access to comprehensive antenatal care, including regular check-ups, education on newborn care, and vaccinations. This can be achieved by improving the availability and quality of antenatal care services, as well as addressing barriers such as cost and transportation.

3. Improve postnatal care: Enhance postnatal care services to provide support and guidance to new mothers in the immediate postpartum period. This can include home visits by trained healthcare providers, breastfeeding support groups, and counseling on newborn care practices.

4. Engage community health workers: Train and empower community health workers to provide basic maternal and newborn care services, including education, counseling, and referrals. Community health workers can play a crucial role in reaching remote and underserved areas where access to healthcare facilities is limited.

5. Strengthen health systems: Invest in strengthening healthcare systems, including infrastructure, equipment, and human resources, to ensure that quality maternal and newborn care services are available and accessible to all women.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could be developed as follows:

1. Define the indicators: Identify key indicators that measure access to maternal health, such as the percentage of pregnant women receiving antenatal care, the percentage of women delivering in healthcare facilities, and the neonatal mortality rate.

2. Collect baseline data: Gather baseline data on the selected indicators before implementing the recommendations. This can be done through surveys, interviews, and data from healthcare facilities and government records.

3. Implement the recommendations: Roll out the recommended interventions, such as awareness campaigns, strengthening antenatal and postnatal care services, and training community health workers. Ensure that these interventions are implemented consistently and monitored closely.

4. Collect post-intervention data: After a sufficient period of time, collect post-intervention data on the selected indicators. This can be done using the same methods as the baseline data collection.

5. Analyze the data: Compare the baseline and post-intervention data to assess the impact of the recommendations on access to maternal health. Calculate the changes in the selected indicators and determine if there has been an improvement in access.

6. Interpret the results: Interpret the findings of the data analysis and draw conclusions about the effectiveness of the recommendations in improving access to maternal health. Identify any gaps or areas for further improvement.

7. Adjust and refine: Based on the findings, make any necessary adjustments or refinements to the recommendations and interventions. Continuously monitor and evaluate the impact of the interventions to ensure ongoing improvement in access to maternal health.

By following this methodology, it is possible to simulate the impact of recommendations on improving access to maternal health and make evidence-based decisions for further interventions and improvements.

Statistics:
Citations: 22
Authors: 3
Identifiers:
DOI: 10.11604/pamj.2017.28.97.13785
Research Areas:
Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Social Determinants
Study Countries:
Kenya
Study Design:
Case-Control Study, Cross Sectional Study, Grounded Theory
Study Approach:
Quantitative
Partilhar isto:
Facebook
Twitter
LinkedIn
WhatsApp
Email