Osrin David, Tumbahangphe Kirti M, Shrestha Dej, Mesko Natasha, Shrestha Bhim P, Manandhar Madan K, Standing Hilary, Manandhar Dharma S, Costello Anthony M de L
International Perinatal Care Unit, Institute of Child Health, University College London, London WC1N 1EH.
BMJ. 2002 Nov 9;325(7372):1063. doi: 10.1136/bmj.325.7372.1063.
To determine home based newborn care practices in rural Nepal in order to inform strategies to improve neonatal outcome.
Cross sectional, retrospective study using structured interviews.
Makwanpur district, Nepal.
5411 married women aged 15 to 49 years who had given birth to a live baby in the past year.
Attendance at delivery, hygiene, thermal care, and early feeding practices.
4893 (90%) women gave birth at home. Attendance at delivery by skilled government health workers was low (334, 6%), as was attendance by traditional birth attendants (267, 5%). Only 461 (8%) women had used a clean home delivery kit, and about half of attendants had washed their hands. Only 3482 (64%) newborn infants had been wrapped within half an hour of birth, and 4992 (92%) had been bathed within the first hour. 99% (5362) of babies were breast fed, 91% (4939) within six hours of birth. Practices with respect to colostrum and prelacteals were not a cause for anxiety.
Health promotion interventions most likely to improve newborn health in this setting include increasing attendance at delivery by skilled service providers, improving information for families about basic perinatal care, promotion of clean delivery practices, early cord cutting and wrapping of the baby, and avoidance of early bathing.
确定尼泊尔农村地区基于家庭的新生儿护理做法，以便为改善新生儿结局的策略提供依据。
采用结构化访谈的横断面回顾性研究。
尼泊尔马克万布尔区。
5411名年龄在15至49岁之间、过去一年生育过活产婴儿的已婚妇女。
分娩时的陪护情况、卫生状况、体温护理及早期喂养做法。
4893名（90%）妇女在家分娩。政府熟练卫生工作者的分娩陪护率较低（334名，6%），传统助产士的陪护率也较低（267名，5%）。只有461名（8%）妇女使用了干净的家庭分娩包，约一半的陪护人员洗手。只有3482名（64%）新生儿在出生半小时内被包裹，4992名（92%）在出生后一小时内洗澡。99%（5362名）的婴儿进行母乳喂养，91%（4939名）在出生后6小时内母乳喂养。初乳和开奶前喂养方面的做法无需担忧。
在这种情况下，最有可能改善新生儿健康的健康促进干预措施包括增加熟练服务提供者的分娩陪护率、改善家庭关于基本围产期护理的信息、推广清洁分娩做法、尽早剪断脐带并包裹婴儿，以及避免过早洗澡。
