Department of Family and Community Health, School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana.
Department of Epidemiology, University for Development Studies, Tamale, Ghana.
BMJ Glob Health. 2022 Mar;7(3). doi: 10.1136/bmjgh-2021-007731.
Skin-to-skin contact is an evidence-based intervention that signifies a situation whereby a newborn is positioned directly on the mother's abdomen or chest in order for them to have direct ventral-to-ventral skin contact. The act of skin-to-skin contact begins immediately after delivery to about 23 hours afterwards. Evidence shows that skin-to-skin contact is important in improving child health outcomes. Nevertheless, evidence on its prevalence and predictors in sub-Saharan Africa (SSA) remains sparse. The study, therefore, estimated the prevalence of skin-to-skin contact between mothers and their newborns, as well as its predictors.
Using data from the recent Demographic and Health Survey conducted between 2015 and 2020 from 17 countries in SSA, we included 131 094 women who gave birth in the last 5 years preceding the survey in the final analysis. We used percentages to summarise the prevalence of skin-to-skin contact. Multilevel logistic regression analysis was used to determine the predictors of skin-to-skin contact. Adjusted odds ratios (ORs) with their corresponding 95% confidence intervals (CIs) were used to present the results of the regression analysis.
Approximately 42% (41.7 to 42.2) of mothers practiced newborn skin-skin contact. The highest prevalence was found in Benin (75.1% (74.1 to 76.0)) and the lowest prevalence in Nigeria (11.7% (11.2 to 12.1)). The likelihood of skin-to-skin contact was higher among women covered by health insurance, those who delivered in health facilities, those in the richest wealth index, women who attended 1-3 antenatal care (ANC) visits and four or more ANC visits, and those with secondary or higher education. The odds of skin-to-skin contact was low among women who delivered by caesarean section (adjusted OR=0.15; 95% CI 0.13 to 0.16).
Considering that less than half of the surveyed women practiced skin-to-skin contact, it is expedient for intensification of advocacy and strict supervision of the practice within the included countries. Informal educational programmes can also be rolled out through various media platforms to sensitise the public and healthcare providers on the need for skin-to-skin contact. These will help maximise the full benefits of skin-to-skin contact and expedite prospects of achieving the Sustainable Development Goal targets 3.1 and 3.2.
皮肤接触是一种循证干预措施,指的是新生儿直接贴在母亲腹部或胸部的位置,以便他们进行直接的腹对腹皮肤接触。皮肤接触的行为从分娩后立即开始,持续约 23 小时。有证据表明,皮肤接触对改善儿童健康结果非常重要。然而,关于其在撒哈拉以南非洲(SSA)的流行率和预测因素的证据仍然很少。因此,本研究旨在估计母亲与新生儿之间皮肤接触的流行率及其预测因素。
我们使用了 2015 年至 2020 年期间在 SSA 的 17 个国家进行的最近一次人口与健康调查的数据,将在调查前 5 年内分娩的 131094 名妇女纳入最终分析。我们使用百分比来总结皮肤接触的流行率。使用多水平逻辑回归分析来确定皮肤接触的预测因素。调整后的优势比(OR)及其 95%置信区间(CI)用于呈现回归分析的结果。
大约有 42%(41.7 到 42.2)的母亲实行了新生儿皮肤接触。皮肤接触率最高的国家是贝宁(75.1%(74.1 到 76.0%)),最低的是尼日利亚(11.7%(11.2 到 12.1%))。在有医疗保险、在医疗机构分娩、在最富裕的财富指数中、参加 1-3 次产前护理(ANC)就诊和 4 次或更多 ANC 就诊以及具有中等或高等教育的妇女中,皮肤接触的可能性更高。剖腹产分娩的妇女皮肤接触的可能性较低(调整后的 OR=0.15;95%CI 0.13 到 0.16)。
鉴于接受调查的妇女中只有不到一半的人实行了皮肤接触,因此有必要在包括这些国家在内的范围内加强宣传和严格监督这种做法。也可以通过各种媒体平台开展非正规教育方案,使公众和医疗保健提供者认识到皮肤接触的必要性。这将有助于最大限度地发挥皮肤接触的全部益处,并加速实现可持续发展目标 3.1 和 3.2 的目标。