International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
BMC Pediatr. 2013 Dec 1;13:198. doi: 10.1186/1471-2431-13-198.
Ethiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia.
We conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection.
The majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care.
Improving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be successful, the coverage of counseling delivered by HEWs and other community volunteers should be increased.
埃塞俄比亚是全球新生儿死亡人数最多的十个国家之一，仅有十分之一的产妇由熟练的接生员接生。推广基本新生儿护理措施是改善新生儿健康结局的一项策略，既可以在社区开展，也可以在医疗机构开展。本文描述了在埃塞俄比亚四个地区最近分娩的妇女（RDWs）报告的新生儿护理做法。
我们采用两阶段整群抽样进行家庭调查，以评估在数据收集前 1 至 7 个月期间分娩活产婴儿的妇女的新生儿护理做法。
大多数妇女到卫生机构进行一次产前护理（ANC）就诊，尽管不到一半的妇女进行了四次或更多次就诊，而且大多数妇女在家中分娩。在这项调查中，大约五分之一的 RDWs 在 ANC 期间与健康推广工作者（HEWs）有过接触，但护士/助产士是最常见的提供者，很少有妇女在产后与任何卫生提供者有过接触。常见的有益新生儿护理做法包括纯母乳喂养（87.6%）、在胎盘娩出前包裹婴儿（82.3%）和脐带干燥护理（65.2%）。在最近分娩的母亲中，报告了一些与世界卫生组织建议相悖的做法，包括在生命的头 24 小时内洗澡（74.7%）、将黄油和其他物质涂抹在脐带（19.9%）上，以及丢弃初乳（44.5%）。结果表明，除了延迟洗澡和皮肤接触外，在大多数基本新生儿护理指标方面，医疗机构分娩和家庭分娩之间没有很大差异。
要改善埃塞俄比亚的新生儿护理和新生儿健康结局，可能需要采取多方面的方法。鉴于低医疗机构分娩率，在社区推广预防新生儿护理措施是一种重要策略，在其他环境中已被证明是有效的。为了使这项策略取得成功，应该增加 HEWs 和其他社区志愿者提供的咨询覆盖范围。
