Understanding new-born care practiced by mothers in Mukono District, Uganda

Abstract

BACKGROUND: Neonatal mortality is persistently high in Uganda, stagnating at 27-29deaths per 1000 live births in over 10 years. This has been greatly attributed to inadequate newborn care and delay of the mothers to recognize the danger signs in their neonates, and hence delay to seek health care. The latter is responsible for half of neonatal deaths in Eastern Uganda. This study aimed to understand newborn care practiced by mothers in Mukono district by assessing newborn care practices and knowledge of newborn danger signs among mothers in Mukono district, in order to guide Mukono district Health Office and Ministry of Health when developing interventions geared towards reducing neonatal mortality in the district. OBJECTIVES: The aim of this study was to determine newborn care practices, knowledge of newborn danger signs and associated factors among mothers in Mukono district. METHODS: This was a cross-sectional study comprising of qualitative and quantitative methods. It was conducted at 6 health facilities, namely; Mukono general hospital, Kojja HCIV, Nakifuma HCIII, Seeta-Nazigo HCIII, Kasawo HCIII and Goma HCIII in Mukono district, in the period of March to June 2020. Quantitative data was collected from 348 mothers using Interviewer-administered questionnaires. Qualitative data was collected from nine In-depth Interviews. Quantitative data was analyzed using STATA v.14.0. Descriptive analysis was done to determine newborn care practices and knowledge of newborn danger signs. To determine factors associated with maternal knowledge of newborn danger signs, we fitted logistic regression models at both bivariate and multivariate analysis. To determine factors associated with newborn care practices, we fitted modified Poisson regression models at both bivariate and multivariate analysis and reported prevalence ratios. Qualitative data was analyzed using content analysis and presented with representative quotations. RESULTS: Overall, 348 mothers were enrolled in the research study, with a mean age of 25 years. Only 22.1% (77/348) had good newborn care knowledge and 19.2% (67/348) mothers practiced good newborn care. Seventeen percent, 63.5%, 33.9%, and 7.2% did not practice good thermal care, cord care, neonatal feeding and eye care practices, respectively. Maternal level of knowledge about the newborn danger signs was good in 11.2% of the mothers, with the most known newborn danger signs being raised body temperature (72.7%) and not feeding well (70.6%). At multivariate analysis, having received training/ advice on newborn care, antenatal care attendance at ≥ 4 months of gestation were associated with maternal knowledge of newborn danger signs. Similarly, maternal age, residence and marital status were factors associated with newborn care among mothers, at multivariable analysis. CONCLUSION: Newborn care among mothers in Mukono district was sub-optimal. There was also low level of maternal knowledge on newborn care and newborn danger signs. The Ministry of Health and Mukono district health office need to intensify neonatal health education during ANC and PNC to all age groups especially young mothers and supportive policies at national level for uptake of newborn care practices need to be introduced in health facilities.