Purpose This study assessed the community acceptance and utilization of maternal and community-based neonatal care services, its barriers, and enablers in southern Ethiopia, 2019 Methods An exploratory qualitative study was conducted among mothers, health extension workers, their supervisors and coordinators in four districts of Sidama Zone, Hawassa University Demographic Surveillance Site An in-depth interview has been carried out with eight health extension workers and eight program coordinators and supervisors, while four focus group discussions were held with eligible mothers Digital recording was applied to record the interview and discussion followed by transcription and thematic analysis through open code Results Study findings reveal that services provided by health extension workers at community level for mothers and their children are highly appreciated and recognized by the community Most of the communities are free from wrong perception regarding the practices Their performance was better in focused antenatal care, but postnatal care and community-based neonatal care were reported to be insignificant Knowledge and skills of HEWs was based on their extended experiences The challenges and opportunities include workload, road inaccessibility, poor supervision, inadequate drugs and equipment supply, shortage of man power and budget at health posts, distance and topography factors of homes from health posts making the visits more difficult, etc To improve uptake of the services, increasing the number of health extension workers in the heath post, supportive supervision, continuous essential drugsm and medical supplies were suggested by participants Conclusion This study shows that services provided by health extension workers for mothers and their neonates are highly appreciated by the community, and there is better change in focused antenatal care services, but postnatal care and sick newborn care are still low Therefore, maternal and neonatal programs should focus on the postnatal home visits and sick newborn care through solving identified barriers

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Community Acceptance and Utilization of Maternal and Community-Based Neonatal Care Services Provided by Health Extension Workers in Rural Sidama Zone: Barriers and Enablers: A Qualitative Study.

Background Mother and newborn skin-to-skin contact (SSC) is an immediate postpartum intervention known to improve the health of newborn and mothers alike. Albeit, there is paucity of data that explored the coverage or factors associated with SSC in Nigeria. Therefore, we aimed to explore the coverage and hierarchical nature of the factors associated with SSC among women of reproductive age in Nigeria. Methods The 2018 Nigeria Demographic and Health Survey (NDHS) data was used for this study. Data on 29,992 women who had ever given birth were extracted for analysis. SSC was the outcome variable as determined by women's report. A multivariable multilevel logistic regression model was used to estimate the fixed and random effects of the factors associated with SSC. Statistical significance was determined at p Results The coverage of SSC was approximately 12.0%. Educated women had higher odds of SSC, when compared with women with no formal education. Those who delivered through caesarean section (CS) had 88% reduction in SSC, when compared with women who had vaginal delivery (OR= 0.12; 95%CI: 0.07, 0.22). Women who delivered at health facility were 15.58 times as likely to practice SSC, when compared with those who delivered at home (OR= 15.58; 95%CI: 10.64, 22.82). Adequate ANC visits and low birth weight significantly increased the odds of SSC. Women from richest household were 1.70 times as likely to practice SSC, when compared with women from poorest household (OR= 1.70; 95%CI: 1.04, 2.79). There was 65% reduction in SSC among women with high rate of community non-use of media, when compared with women from low rate of community non-use of media (OR= 0.35; 95%CI: 0.20, 0.61). Conclusion SSC coverage was low in Nigeria. Moreover, individual, household and community level factors were associated with SSC. More enlightenment should be created among women to bring to limelight the importance of SSC specifically to newborn's health.

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Coverage and factors associated with mother and newborn skin-to-skin contact in Nigeria: a multilevel analysis.

Background:Health extension workers (HEWs) are primarily been assigned in rural areas of Ethiopia to provide maternal and child health services. Few studies have been done to investigate HEWs’ cont...

https://journals.sagepub.com/doi/pdf/10.1177/2333392819835138

Health Extension Workers Involvement in the Utilization of Focused Antenatal Care Service in Rural Sidama Zone, Southern Ethiopia: A Cross-Sectional Study.

Introduction Skin-to-skin contact is an evidence-based intervention that signifies a situation whereby a newborn is positioned directly on the mother’s abdomen or chest in order for them to have direct ventral-to-ventral skin contact. The act of skin-to-skin contact begins immediately after delivery to about 23 hours afterwards. Evidence shows that skin-to-skin contact is important in improving child health outcomes. Nevertheless, evidence on its prevalence and predictors in sub-Saharan Africa (SSA) remains sparse. The study, therefore, estimated the prevalence of skin-to-skin contact between mothers and their newborns, as well as its predictors. Methods Using data from the recent Demographic and Health Survey conducted between 2015 and 2020 from 17 countries in SSA, we included 131 094 women who gave birth in the last 5 years preceding the survey in the final analysis. We used percentages to summarise the prevalence of skin-to-skin contact. Multilevel logistic regression analysis was used to determine the predictors of skin-to-skin contact. Adjusted odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were used to present the results of the regression analysis. Results Approximately 42% (41.7 to 42.2) of mothers practiced newborn skin-skin contact. The highest prevalence was found in Benin (75.1% (74.1 to 76.0)) and the lowest prevalence in Nigeria (11.7% (11.2 to 12.1)). The likelihood of skin-to-skin contact was higher among women covered by health insurance, those who delivered in health facilities, those in the richest wealth index, women who attended 1–3 antenatal care (ANC) visits and four or more ANC visits, and those with secondary or higher education. The odds of skin-to-skin contact was low among women who delivered by caesarean section (adjusted OR=0.15; 95% CI 0.13 to 0.16). Conclusion Considering that less than half of the surveyed women practiced skin-to-skin contact, it is expedient for intensification of advocacy and strict supervision of the practice within the included countries. Informal educational programmes can also be rolled out through various media platforms to sensitise the public and healthcare providers on the need for skin-to-skin contact. These will help maximise the full benefits of skin-to-skin contact and expedite prospects of achieving the Sustainable Development Goal targets 3.1 and 3.2.

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Mother and newborn skin-to-skin contact in sub-Saharan Africa: prevalence and predictors

Health professionals' knowledge and practice of essential newborn care at public health facilities in Bench-Sheko Zone, southwest Ethiopia.

BACKGROUND Globally, there has been progress in reducing maternal and under-5 child deaths in the past 2 decades; however, the progress in reducing newborn mortality has been slower with estimated 3 million neonatal deaths per year. In Ethiopia, unhealthy newborn care is common at home deliveries compared with institutional births that might be associated with neonatal deaths. The purpose of the current study was to assess the practices of immediate newborn care at home and institutional deliveries in rural Sidama Zone, 2017. METHODS A population-based cross-sectional survey was used. The study was conducted in 5 districts of Sidama Zone, from January 21 to February 4, 2017. A total of 2300 mothers who gave live births in the past 6 months were selected using a 2-stage cluster sampling methods. Data were entered, cleaned, and recoded using Epi Data and SPSS for analysis. Accordingly, descriptive and bivariate analyses were done, and the results are presented using P values. RESULTS The response rate was 99% (2279/2300). About one-third of the mothers are in the age group of 20 to 24 years, and 94.6% of them had at least 1 antenatal care follow-up. Most (72%) mothers delivered at health facilities. The practices of skin to skin care of the babies was 52% (61% at health facilities, 28% at home; P < .002). Baby bathing delay for at least 24 hours was 78% and clean cord care was 73% overall (home 21% vs health institution 93.6%). The cord was not tied in 11.6% of cases all of whom were home births ( P < .001). As to immediate breastfeeding of the child, most (78%) of the babies were put to the breast within an hour of birth with no significant difference between the 2 places of births ( P = .75). CONCLUSION In this study, giving birth at health facilities did not make immediate newborn care practices universal, but unhealthy practices were more common among home births. Therefore, more efforts to promote community-based immediate newborn care are needed with great emphasis to proper thermal care.

https://journals.sagepub.com/doi/pdf/10.1177/2150132718812181

Achamyelesh G

Papers

The Levels of Neonatal Care Practices at Health Facilities and Home Deliveries in Rural Sidama Zone, Southern Ethiopia.