Delivery, immediate newborn and cord care practices in Pemba Tanzania: A qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices

Usha Dhingra, Joel Gittelsohn, Atifa M. Suleiman, Shekhia M. Suleiman, Arup Dutta, Said M. Ali, Shilpi Gupta, Robert E Black, Sunil Sazawal

Research output: Contribution to journalArticle

Abstract

Background: Deaths during the neonatal period account for almost two-thirds of all deaths in the first year of life and 40 percent of deaths before the age of five. Most of these deaths could be prevented through proven cost-effective interventions. Although there are some recent data from sub-Saharan Africa, but there is paucity of qualitative data from Zanzibar and cord care practices data from most of East Africa. We undertook a qualitative study in Pemba Island as a pilot to explore the attitudes, beliefs and practices of the community and health workers related to delivery, newborn and cord care with the potential to inform the main chlorhexidine (CHX) trial.Methods: 80 in-depth interviews (IDI) and 11 focus group discussions (FGD) involving mothers, grandmothers, fathers, traditional birth attendants and other health service providers from the community were undertaken. All IDIs and FGDs were audio taped, transcribed and analyzed using ATLAS ti 6.2.Results: Poor transportation, cost of delivery at hospitals, overcrowding and ill treatment by hospital staff are some of the obstacles for achieving higher institutional delivery. TBAs and health professionals understand the need of using sterilized equipments to reduce risk of infection to both mothers and their babies during delivery. Despite this knowledge, use of gloves during delivery and hand washing before delivery were seldom reported. Early initiation of breastfeeding and feeding colostrum was almost universal. Hospital personnel and trained TBAs understood the importance of keeping babies warm after birth and delayed baby's first bath. The importance of cord care was well recognized in the community. Nearly all TBAs counseled the mothers to protect the cord from dust, flies and mosquitoes or any other kind of infections by covering it with cloth. There was consensus among respondents that CHX liquid cord cleansing could be successfully implemented in the community with appropriate education and awareness.Conclusion: The willingness of community in accepting a CHX cord care practice was very high; the only requirement was that a MCH worker needs to do and demonstrate the use to the mother.Trial registration: ClinicalTrials.gov: NCT01528852.

Original languageEnglish (US)
Article number173
JournalBMC Pregnancy and Childbirth
Volume14
Issue number1
DOIs
StatePublished - May 22 2014

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Indian Ocean Islands
Tanzania
Community Hospital
Chlorhexidine
Mothers
Newborn Infant
Hospital Personnel
Costs and Cost Analysis
Hand Disinfection
Eastern Africa
Colostrum
Africa South of the Sahara
Midwifery
Infection
Breast Feeding
Culicidae
Focus Groups
Dust
Baths
Islands

Keywords

  • Breastfeeding
  • Community
  • Cord care
  • Delivery
  • Newborn health
  • Traditional practices

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Medicine(all)

Cite this

Delivery, immediate newborn and cord care practices in Pemba Tanzania : A qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices. / Dhingra, Usha; Gittelsohn, Joel; Suleiman, Atifa M.; Suleiman, Shekhia M.; Dutta, Arup; Ali, Said M.; Gupta, Shilpi; Black, Robert E; Sazawal, Sunil.

In: BMC Pregnancy and Childbirth, Vol. 14, No. 1, 173, 22.05.2014.

Research output: Contribution to journalArticle

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AU - Suleiman, Atifa M.

AU - Suleiman, Shekhia M.

AU - Dutta, Arup

AU - Ali, Said M.

AU - Gupta, Shilpi

AU - Black, Robert E

AU - Sazawal, Sunil

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KW - Newborn health

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