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加纳劳腊地区基本新生儿护理措施的普及率及决定因素

Prevalence and determinants of essential newborn care practices in the Lawra District of Ghana.

作者信息

Saaka Mahama, Ali Fusena, Vuu Felicia

机构信息

University for Development Studies, School of Allied Health Sciences, P O Box, 1883, Tamale, Ghana.

出版信息

BMC Pediatr. 2018 May 24;18(1):173. doi: 10.1186/s12887-018-1145-4.

Abstract

BACKGROUND

There was less than satisfactory progress, especially in sub-Saharan Africa, towards child and maternal mortality targets of Millennium Development Goals (MDGs) 4 and 5. The main aim of this study was to describe the prevalence and determinants of essential new newborn care practices in the Lawra District of Ghana.

METHODS

A cross-sectional study was carried out in June 2014 on a sample of 422 lactating mothers and their children aged between 1 and 12 months. A systematic random sampling technique was used to select the study participants who attended post-natal clinic in the Lawra district hospital.

RESULTS

Of the 418 newborns, only 36.8% (154) was judged to have had safe cord care, 34.9% (146) optimal thermal care, and 73.7% (308) were considered to have had adequate neonatal feeding. The overall prevalence of adequate new born care comprising good cord care, optimal thermal care and good neonatal feeding practices was only 15.8%. Mothers who attained at least Senior High Secondary School were 20.5 times more likely to provide optimal thermal care [AOR 22.54; 95% CI (2.60-162.12)], compared to women had no formal education at all. Women who received adequate ANC services were 4.0 times (AOR  =  4.04 [CI: 1.53, 10.66]) and 1.9 times (AOR  =  1.90 [CI: 1.01, 3.61]) more likely to provide safe cord care and good neonatal feeding as compared to their counterparts who did not get adequate ANC. However, adequate ANC services was unrelated to optimal thermal care. Compared to women who delivered at home, women who delivered their index baby in a health facility were 5.6 times more likely of having safe cord care for their babies (AOR = 5.60, Cl: 1.19-23.30), p = 0.03.

CONCLUSIONS

The coverage of essential newborn care practices was generally low. Essential newborn care practices were positively associated with high maternal educational attainment, adequate utilization of antenatal care services and high maternal knowledge of newborn danger signs. Therefore, greater improvement in essential newborn care practices could be attained through proven low-cost interventions such as effective ANC services, health and nutrition education that should span from community to health facility levels.

摘要

背景

在实现千年发展目标4和5中儿童及孕产妇死亡率目标方面,进展不尽人意,尤其是在撒哈拉以南非洲地区。本研究的主要目的是描述加纳劳腊区基本新生儿护理措施的普及率及其决定因素。

方法

2014年6月,对422名哺乳期母亲及其1至12个月大的孩子进行了一项横断面研究。采用系统随机抽样技术,选取在劳腊区医院产后诊所就诊的研究参与者。

结果

在418名新生儿中,只有36.8%(154名)被判定接受了安全的脐带护理,34.9%(146名)接受了最佳的体温护理,73.7%(308名)被认为获得了充足的新生儿喂养。包含良好脐带护理、最佳体温护理和良好新生儿喂养措施的充足新生儿护理总体普及率仅为15.8%。与完全没有接受过正规教育的女性相比,至少接受过高中教育的母亲提供最佳体温护理的可能性高20.5倍(调整后比值比为22.54;95%置信区间为2.60至162.12)。接受过充足产前护理服务的女性提供安全脐带护理和良好新生儿喂养的可能性分别比未接受充足产前护理的女性高4.0倍(调整后比值比为4.04,置信区间为1.53至10.66)和1.9倍(调整后比值比为1.90,置信区间为1.01至3.61)。然而,充足的产前护理服务与最佳体温护理无关。与在家分娩的女性相比,在医疗机构分娩头胎的女性为其婴儿提供安全脐带护理的可能性高5.6倍(调整后比值比为5.60,置信区间为1.19至23.30),p = 0.03。

结论

基本新生儿护理措施的覆盖率普遍较低。基本新生儿护理措施与产妇高学历、充分利用产前护理服务以及产妇对新生儿危险信号的高知晓率呈正相关。因此,通过有效的产前护理服务、从社区到医疗机构层面的健康与营养教育等已证实的低成本干预措施,可在基本新生儿护理措施方面取得更大改善。

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