Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

Abstract

Objective: To learn about household maternal and newborn health knowledge and practices to aid the design of newborn programming within Save the Children's Haripur Program.Study Design: In April, we conducted 43 semi-structured interviews (SSIs) and 34 focus group discussions among men, women of reproductive age and health service providers; in September, we added 21 SSIs among new mothers, new fathers and dais. Two investigators analyzed the findings according to themes within six care types: antenatal, delivery, immediate newborn, routine postpartum, special maternal and special newborn.Result: Findings indicated poor maternal diet and antenatal careseeking. Home delivery with an untrained dai was the norm. Respondents knew about benefits of clean delivery, but rarely put knowledge into practice. Knowledge and practices for maintaining the newborn's warmth were good. Delayed initiation of breastfeeding, avoidance of colostrum and prelacteal feeding were almost universal. Unhygienic cord care, including an unclean cut and application of ghee on the cord-stump, was the norm. After delivery, mothers often maintained low fluid intake but otherwise reported healthy nutritional practices. Knowledge of some danger signs in newborns was common, but timely action upon recognition was not. Conclusion:Although the findings illustrate some beneficial practices, many reported practices are harmful to the newborn. These findings, consistent with the sparse existing data in Pakistan, inform program interventions for household-level behavioral change.

Feeding Practices and Morbidity Pattern of Infants in a Rural Area of Puducherry-A Follow Up Study

“…Similar observations were reported from two studies conducted in Bangalore [13,14]. However, studies from other regions of India and other countries also showed even higher percentage of mothers discarding colostrum for first two days [10,14,[16][17][18].…”

“…The practice of giving pre-lacteal feed is observed in many countries also. Studies from rural Egypt, South Nepal and Pakistan [8][9][10] reported that the percentage of newborns that were given pre-lacteal feeds was 44%, 55.6% and 87.6% respectively, which were higher compared to the present study. Studies from other parts of India also reported the practice of giving prelacteal feeds [11][12][13][14].…”

Neonatal hypothermia in low resource settings: a review

“…As the risk to the mother's life is perceived to be higher, it is a common practice to focus attention primarily on the mother until the delivery of the placenta, while the newborn is left unattended, sometimes on the ground, leading to prolonged exposure. 67,77 Immediate drying and wrapping of the baby is not a common practice, 67,66,77 and leads to further heat loss. Early bathing is common, sometimes with vigorous scrubbing of the skin to remove the vernix, especially when local knowledge dictates that the vernix is a 'dirty' or polluting substance.…”

“…The application of topical agents, including paraffin 39,69 petrolatum, mineral oil and lanolin, 69 or corn, 77 sunflower, sesame or safflower oil, 69,79,80,101 have been shown to reduce transepidermal water loss and as well as loss of heat. This is especially relevant for preterm newborns with an immature skin barrier.…”

Towards an understanding of the multilevel factors associated with maternal health care utilization in Uttar Pradesh, India

“…Cultural norms within the community or district, for example, can hinder a woman from seeking or receiving health care. These cultural norms can also take place at the level of the individual, where a woman’s personal beliefs or her family’s belief system can either facilitate or impede the process of seeking care [6,8,10]. …”