Knowledge and Attitude of Postnatal Mothers on Essential Newborn Care Practices at Kenyatta National Hospital

Abstract

INTRODUCTION: Of the 130 million babies born yearly, nearly 4 million die in neonatal period 1. Almost all deaths occur in low and middle income countries with the highest rates in sub-Saharan Africa 2. Kenya Demographic Health Survey (KDHS) 2008/9 places neonatal mortality rate at 31 deaths per 1,000 live births with only a marginal decline from 2003 rate of 33 deaths per 1,000 live births. Essential Newborn Care practices, developed by WHO, are simple measures that can improve neonatal outcomes. The aim of the study was to assess maternal knowledge and attitude towards selected aspects of essential newborn care practices. METHODOLOGY: A hospital based cross-sectional study was conducted in Kenyatta National Hospital. A total of 380 postnatal mothers were interviewed using structured pretested questionnaires. Knowledge was assessed using closed and open ended questions. A score of one was allocated for correct knowledge and zero for incorrect. Attitude was assessed using a five point Likert scale. Data was analysed using SPSS version 18. RESULTS: More than 90% of mothers knew of breastfeeding on demand, exclusive breastfeeding and colostrum use. Only 17.8 % of mothers identified BCG and OPV as birth vaccines while 7 % of mothers believed vaccines were harmful. Modes of thermoregulation identified included kangaroo care (7%), warm room (4%) and warm clothing (93%). Only 4 mothers knew the cord should be left clean and dry without applying any substances. At least 6 of 13 newborn danger signs were identified by more than 90% of mothers. Positive attitude was noted most consistently on breastfeeding and cord care. Multivariate analysis showed poor maternal knowledge was associated with lack of antenatal education on newborn care (OR 3.3, p 0.003, CI 1.5-7.4), no ANC visits (OR 5.1, p 0.018, CI 1.3-19.3) or incomplete ANC visits (OR 2.5, p 0.001, CI 1.5-4.2). CONCLUSION: Knowledge gaps exist in cord care, eye care, and immunisation. Postnatal mothers have a positive attitude towards cord care and breastfeeding but negative attitude towards other components of newborn care. Lack of antenatal education on newborn care and those who fail to attend all the recommended four antenatal clinic are likely to have poor knowledge and should be targeted for newborn education.