BackgroundRecommendations for care in the first week of a newborn’s life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries.MethodsData were collected in the same way in each site and included 16–20 narrative interviews with recent mothers, eight observations of neonatal bathing, and in-depth interviews with 12–16 mothers, 9–12 grandmothers, eight health workers and 0–12 birth attendants in each site.ResultsWe found similarities across sites in relation to understanding the importance of warmth, a lack of opportunities for skin to skin care, beliefs about the importance of several baths per day and beliefs that the Vernix caseosa was related to poor maternal behaviours. There was variation between sites in beliefs and practices around wrapping and drying after delivery, and the timing of the first bath with recent behavior change in some sites. There was near universal early bathing of babies in both Nigerian sites. This was linked to a deep-rooted belief about body odour. When asked about keeping the baby warm, respondents across the sites rarely mentioned recommended thermal care practices, suggesting that these are not perceived as salient.ConclusionMore effort is needed to promote appropriate thermal care practices both in facilities and at home. Programmers should be aware that changing deep rooted practices, such as early bathing in Nigeria, may take time and should utilize the current beliefs in the importance of neonatal warmth to facilitate behaviour change.

ObjectivesTo explore roles and responsibilities in newborn care in the intra‐ and postpartum period in Nigeria, Tanzania and Ethiopia.MethodsQualitative data were collected using in‐depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses.ResultsWe found that birth attendants were the main decision‐makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first‐time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision‐maker in the family.ConclusionInterventions should move beyond a focus on the mother–child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change.

Data for this study on skin care practices and emollient use in four African sites were collected using in-depth interviews, focus-group discussions and observations. Respondents were mothers, grandmothers, fathers, health workers, birth attendants and people selling skin-care products. Analysis included content and framework analyses.Emollient use was a normative practice in all sites, with frequent application from an early age in most sites. There were variations in the type of emollients used, but reasons for use were similar and included improving the skin, keeping the baby warm, softening/strengthening the joints/bones, shaping the baby, ensuring flexibility and encouraging growth and weight gain. Factors that influenced emollient choice varied and included social pressure, cost, availability and deep-rooted traditional norms. Massage associated with application was strong and potentially damaging to the skin in some sites.Given the widespread use of emollients, the repeated exposure of newborns in the first month of life and the potential impact of emollients on mortality, trials such as those that have been conducted in Asia are needed in a range of African settings.

Background: Neonatal mortality remains unacceptably high in most sub-Saharan and Asian communities, where cultural practices and poor antenatal care are common. Newborn care practices play a key role in preventing neonatal deaths. Aims: This study aimed to examine similarities and variations in newborn care between two major ethnic groups in northeast Nigeria. Subjects And Methods: Qualitative methods involving narratives, observations, focus group discussions, and in-depth interviews were used to collect data from recent mothers (ten per ethnic group) and grandmothers from the Babur/Bura and Kanuri ethnic groups in Borno State, Northeast Nigeria. A snowballing sampling technique was used to select the participants within four communities/villages (two for each ethnic group). Results: Babies were bathed within 30 to 45 minutes after delivery by mothers in both groups, except in case of ill health of the child and/or mother. Various substances were applied to the cord even though hygienic cord-cutting practice was reported. With the exception of early bathing, good thermal care practices were observed in both groups. Both groups applied emollients on the skin of the babies, but Bura preferred the use of shea butter to oils and lotion. Various substances were applied to other parts of the body of the baby, such as the fontanelle (Mahogany oil), anus (Neem oil and Mahogany oil), and circumcision wound (engine oil) more so among the Bura than the Kanuri. None of the substances were deemed to be harmful. Conclusion: Similarities and variations in newborn care exist between the two ethnic groups. There is a need for health education and promotion to encourage and facilitate positive behavioral change from old traditional practices to healthy newborn care practices among the Babur/Bura and Kanuri ethnic groups.