Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey
Abstract Background Neonatal infections caused by unsafe umbilical cord practices account for the majority of neonatal deaths in Nigeria. We examined the trends in umbilical cord care practices between 2012 and 2015 that coincided with the introduction of chlorhexidine digluconate 7.1% gel in Bauchi...
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| Language: | English |
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BMC
2017-11-01
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| Series: | BMC Pregnancy and Childbirth |
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| Online Access: | http://link.springer.com/article/10.1186/s12884-017-1551-x |
| _version_ | 1818935501526138880 |
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| author | Dele Abegunde Nosa Orobaton Katherine Beal Amos Bassi Moyosola Bamidele Toyin Akomolafe Francis Ohanyido Olayinka Umar-Farouk Saba’atu Danladi |
| author_facet | Dele Abegunde Nosa Orobaton Katherine Beal Amos Bassi Moyosola Bamidele Toyin Akomolafe Francis Ohanyido Olayinka Umar-Farouk Saba’atu Danladi |
| author_sort | Dele Abegunde |
| collection | DOAJ |
| description | Abstract Background Neonatal infections caused by unsafe umbilical cord practices account for the majority of neonatal deaths in Nigeria. We examined the trends in umbilical cord care practices between 2012 and 2015 that coincided with the introduction of chlorhexidine digluconate 7.1% gel in Bauchi and Sokoto States. Methods We obtained data from three rounds of lot quality assurance samples (LQAS) surveys conducted in 2012, 2013 and 2015. Households were randomly sampled in each round that totaled 1140 and 1311 households in Bauchi and Sokoto States respectively. Mothers responded to questions on cord care practices in the last delivery. Coverage estimates of practice indicators were obtained for each survey period. Local Government Area (LGA) estimates for each indicator were obtained with α ≤ 5%, and β ≤20% statistical errors and aggregated to State-level estimates with finite sample correction relative to the LGA population. Results Over 75 and 80% of deliveries in Bauchi and Sokoto States respectively took place at home. The proportion of deliveries in public facilities reported by mothers ranged from 19% in 2012 to 22.4% in 2015 in Bauchi State and from 12.9 to 13.2% in 2015 in Sokoto State. Approximately 50% of deliveries in Bauchi and more than 80% in Sokoto States were assisted by traditional birth attendants (TBAs) or relatives and friends, with little change in the survey periods. In Bauchi and in Sokoto States, over 75% and over 80% of newborn cords were cut with razor blades underscoring the pervasive role of the TBAs in the immediate postpartum period. Use of chlorhexidine digluconate 7.1% gel for cord dressing significantly increased to the highest level in 2015 in both States. Health workers who attended deliveries in health facilities switched from methylated spirit to chlorhexidine. There were no observable changes in cord care practices among the TBAs. Conclusion Unsafe umbilical cord care practices remained prevalent in Bauchi and Sokoto States of Nigeria, although a recent introduction of chlorhexidine digluconate 7.1% gel positively changed the cord care practices toward safer practices among public health providers. TBAs, friends and relatives played the strongest immediate postpartum roles and mostly retained the unsafe cord care practices such as use of ash, cow dung and hot compress. We recommend that existing TBAs are retrained and refocused to forge stronger links between communities and the primary health centers to increase mothers’ access to skilled birth attendants. |
| first_indexed | 2024-12-20T05:21:10Z |
| format | Article |
| id | doaj.art-f5d8c343c4ca413c8fbd874123b9b2bf |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-20T05:21:10Z |
| publishDate | 2017-11-01 |
| publisher | BMC |
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| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-f5d8c343c4ca413c8fbd874123b9b2bf2022-12-21T19:52:01ZengBMCBMC Pregnancy and Childbirth1471-23932017-11-0117111110.1186/s12884-017-1551-xTrends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling surveyDele Abegunde0Nosa Orobaton1Katherine Beal2Amos Bassi3Moyosola Bamidele4Toyin Akomolafe5Francis Ohanyido6Olayinka Umar-Farouk7Saba’atu Danladi8Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.JSI Research & Training Institute, IncTargeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.Targeted States High Impact Project (TSHIP), JSI Research & Training Institute, Inc.FUTURES- Targeted States High Impact Project (TSHIP)Abstract Background Neonatal infections caused by unsafe umbilical cord practices account for the majority of neonatal deaths in Nigeria. We examined the trends in umbilical cord care practices between 2012 and 2015 that coincided with the introduction of chlorhexidine digluconate 7.1% gel in Bauchi and Sokoto States. Methods We obtained data from three rounds of lot quality assurance samples (LQAS) surveys conducted in 2012, 2013 and 2015. Households were randomly sampled in each round that totaled 1140 and 1311 households in Bauchi and Sokoto States respectively. Mothers responded to questions on cord care practices in the last delivery. Coverage estimates of practice indicators were obtained for each survey period. Local Government Area (LGA) estimates for each indicator were obtained with α ≤ 5%, and β ≤20% statistical errors and aggregated to State-level estimates with finite sample correction relative to the LGA population. Results Over 75 and 80% of deliveries in Bauchi and Sokoto States respectively took place at home. The proportion of deliveries in public facilities reported by mothers ranged from 19% in 2012 to 22.4% in 2015 in Bauchi State and from 12.9 to 13.2% in 2015 in Sokoto State. Approximately 50% of deliveries in Bauchi and more than 80% in Sokoto States were assisted by traditional birth attendants (TBAs) or relatives and friends, with little change in the survey periods. In Bauchi and in Sokoto States, over 75% and over 80% of newborn cords were cut with razor blades underscoring the pervasive role of the TBAs in the immediate postpartum period. Use of chlorhexidine digluconate 7.1% gel for cord dressing significantly increased to the highest level in 2015 in both States. Health workers who attended deliveries in health facilities switched from methylated spirit to chlorhexidine. There were no observable changes in cord care practices among the TBAs. Conclusion Unsafe umbilical cord care practices remained prevalent in Bauchi and Sokoto States of Nigeria, although a recent introduction of chlorhexidine digluconate 7.1% gel positively changed the cord care practices toward safer practices among public health providers. TBAs, friends and relatives played the strongest immediate postpartum roles and mostly retained the unsafe cord care practices such as use of ash, cow dung and hot compress. We recommend that existing TBAs are retrained and refocused to forge stronger links between communities and the primary health centers to increase mothers’ access to skilled birth attendants.http://link.springer.com/article/10.1186/s12884-017-1551-xUmbilical cord practicesChlorhexidineTraditional birth attendantsNigeria |
| spellingShingle | Dele Abegunde Nosa Orobaton Katherine Beal Amos Bassi Moyosola Bamidele Toyin Akomolafe Francis Ohanyido Olayinka Umar-Farouk Saba’atu Danladi Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey BMC Pregnancy and Childbirth Umbilical cord practices Chlorhexidine Traditional birth attendants Nigeria |
| title | Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey |
| title_full | Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey |
| title_fullStr | Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey |
| title_full_unstemmed | Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey |
| title_short | Trends in newborn umbilical cord care practices in Sokoto and Bauchi States of Nigeria: the where, who, how, what and the ubiquitous role of traditional birth attendants: a lot quality assurance sampling survey |
| title_sort | trends in newborn umbilical cord care practices in sokoto and bauchi states of nigeria the where who how what and the ubiquitous role of traditional birth attendants a lot quality assurance sampling survey |
| topic | Umbilical cord practices Chlorhexidine Traditional birth attendants Nigeria |
| url | http://link.springer.com/article/10.1186/s12884-017-1551-x |
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