Association of antenatal care and place of delivery with newborn care practices: evidence from a cross-sectional survey in rural Uttar Pradesh, India

Abstract

BackgroundAppropriate immediate newborn care is vital for neonatal survival. Antenatal period is a crucial time to impart knowledge and awareness to mothers regarding newborn care, either during facility visits or during home visits by community health workers (CHWs) especially in the rural context. In this paper, we report newborn care practices in rural Uttar Pradesh (UP) and have explored association between newborn care practices with antenatal care, contact with community health workers during pregnancy and place of childbirth.MethodsWe use cross-sectional baseline data (which is part of a larger intervention project) collected from 129 gram panchayats (GPs) from 15 administrative blocks spread over five districts of UP in 2013. From currently married women (n = 2208) of 15–49 years, who delivered 15 months prior to the survey, we collected information on women’s demographic and socio-economic characteristics, knowledge and practice of reproductive, maternal, newborn, child health and nutrition behaviours. Association of newborn practices with antenatal care, contacts by community health worker during pregnancy and place of childbirth were tested using random intercept logistic regression, adjusting for socio-economic and demographic factors and accounting for clustering at the GP and block levels.ResultsEighty-three percent of 2208 mothers received ANC, but only half of the respondents received a minimum of three ANC visits. More than two thirds of respondents delivered at a health facility. Practice of newborn care was poor: merely one fourth of women practised clean cord care, one third of women followed good breastfeeding practices (initiation with an hour of birth, fed colostrum and did not give pre-lacteal feeds) and one third provided adequate thermal care (kept baby warm and delayed bathing). Only 5% followed all above practices with evidence of clustering of newborn care practices at the block and GP levels. While facility-based childbirth was strongly associated with appropriate newborn care practices, ANC visits and contacts with CHWs was not associated with all newborn care practices.ConclusionThe quality of ANC care provided needs to be improved to have an impact on newborn care practices. Our finding emphasizes the importance of facility-based birthing. There is a need for training CHWs to strengthen their counselling skills on newborn care. Variation of newborn care practices between communities should be taken into consideration while implementing any intervention to optimize benefits.

The Knowledge of Danger Signs of Obstetric Complications Among Women in Rural India: Evaluating an Integrated Microfinance and Health Literacy Program

“…Studies showed that, even in the case of villages where SHG only programs were present, membership was not associated with higher antenatal care, institutional delivery or post-natal care (58)(59)(60). While increasing parity is also likely to be correlated with increasing age, the lower level of knowledge of danger signs found in our study with increasing parity could also be in uenced by increasing age.…”

“…Studies elsewhere have shown that membership in the SHG only program has a limited association with improving routine maternal and newborn health (MNH) practices. For example, three recent studies in rural UP showed that membership in SHG only programs did not improve the practice of three antenatal care check-ups, institutional delivery or post-natal care, but the selectively improved practice of newborn cord care (58)(59)(60). Similar inferences were also drawn from a larger 2019 study from UP that concluded that there were signi cant improvements (5-11 percentage points) in desired Maternal and Neonatal…”

Essential Newborn Care Utilization and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis

“…This can be explained by the fact that mothers who received training on essential newborn care during ANC, delivery and PNC periods could better understand the importance of the practice of essential newborn care [30]. There may be other possible reasons community health workers (HEWs) could discuss and educate about ENBC during monthly meeting [31]. Thus, to support the utilization of health facilities for prevent and treat neonatal mortality and morbidity, prompt postnatal care (PNC) for the mother and the child is important.…”

Antenatal care practice among Pregnant Women in a selected rural area of Bangladesh

“…Similar finding was reflected in a study by Niveditha Det al in India. 14 Regarding the reason for selecting UHC for the place of delivery, 51.3% respondents preferred for avoiding pregnancy related complications (Fig -1)…”