BackgroundIn Nepal, hypothermia is a major risk factor for newborn survival, but the country’s public health care sector has insufficient capacity to improve newborn survival given the burden imposed by distance to health facilities and cost. Low-cost technology to provide newborn thermal care in resource-limited environments exists, but lacks effective distribution channels.This study aims to develop a private sector distribution model for dedicated newborn thermal care technology to ensure equitable access to thermal protection and ultimately improve newborn health in Nepal.MethodsWe conducted a document analysis of newborn health policy in Nepal and a scoping literature review of approaches to newborn hypothermia in the region, followed by qualitative interviews with key stakeholders of newborn health in Nepal.ResultsCurrent solutions addressing newborn hypothermia range from high-technology, high-cost incubators to low-cost behavioral interventions such as skin-to-skin care. However, none of these interventions  are currently implemented at scale. A distribution model that provides incentives for community health volunteers and existing public health services in Nepal can deliver existing low-cost infant warmers to disadvantaged mothers where and when needed. Newborn technology can serve as an adjunct to skin-to-skin care and potentially create demand for newborn care practices.ConclusionHarnessing market forces could promote public health by raising awareness of newborn challenges, such as newborn hypothermia, and triggering demand for appropriate health technology and related health promotion behaviors. Market approaches to promoting public health have been somewhat neglected, especially in economically disadvantaged and vulnerable populations, and deserve greater attention in Nepal and other settings with limited public health service delivery capacity.

This article reports on initial findings of a continuing longitudinal study investigating the relationships of health beliefs as conceptualized by the health belief model and the use of well-baby services among first-time black mothers. The health beliefs of mothers about their babies were measured before the babies were born and during their use of the services at the baby's first and sixth-month visits. Mothers in the sample who became nonusers of the well-baby services were also interviewed. This report describes the results of the first interview of the 662 females who composed the sample for the study, including the following characteristics of a minority, high-risk population: health orientation, health beliefs about their unborn babies, and use of health services. These findings are discussed with implications for community health nursing practice with maternal clients.

This prospective, longitudinal investigation examined factors that influenced the use of well-baby services among a low-income, minority, high-risk group. The health belief model was used as the theoretical framework. Data were collected from 44 primiparous, black mothers attending an urban maternalchild health care clinic by interviews at the first and sixth months after the birth of their infants. Analysis focused on the cues component of the model and explored the kinds of cues that influenced the mothers to bring their babies to the well-baby clinic. One important finding was that for mothers influenced by health information from radio or television, FYI commercials on television were most often reported. Cecilia E. Dowkinr, Ph.D., R.N. is AJsirlnnl Professor in Community Health Nursing of the Universiry of Michigan School of Nursing, Ann Arbor, Michigon. Noom' E. Ervin, Ph.D., R.N. is Assistant Professor in Public Heolth Nursing ot the College of Nun@ Univenity of Illinois, Chicogo, Illinois. A p p r e c W n is expressed to the Chicago Deportment of Heolth for their cooper&.on with this reseorch. Address correspondence to Cecilia E. Dawkins, Ph.D., R.N., University of Michigan Shoo1 of Nursing, Community Health Nursing, 400 N o h Ingalk, Room 3187, Ann Arbor, MI 481094486. Telephone (313) 747-0341.As part of a study done to investigate mothers' health beliefs and their use of well-baby services, variables thought to result in their actual attendance to the clinic were explored. This paper examines factors that appear to have motivated 44 mothers to bring their babies to a well-child clinic for their one-and six-month visits.Well-baby services include physical examination, immunizations, growth and development screening, counseling, and referral for appropriate special services. The benefits of these services include early detection of health and related problems (e.g., developmental, behavioral) and fostering of good health practices to promote optimum levels of wellness. Health personnel in well-child and community-oriented facilities devote much attention to the development of good health-maintenance practices among family members. Community health nurses in particular emphasize to new mothers the importance of regular well-baby clinic visits and obtaining immunizations. Nurses find, however, that clients, especially those from poor and minority groups, frequently do not make appointments or fail to keep those made. These kinds of client behaviors contribute to the frustration of community health nurses and the apparent ineffectiveness of nursing interventions. More effective models for nursing interventions could assist with the problem of inadequate health supervision of children.