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乌干达西南部一家地区转诊医院新生儿和幼儿照顾者的新生儿护理知识和实践。

Newborn care knowledge and practices among care givers of newborns and young infants attending a regional referral hospital in Southwestern Uganda.

机构信息

Mbarara University of Science and Technology, Mbarara, Uganda.

Mbarara Regional Referral Hospital, Mbarara, Uganda.

出版信息

PLoS One. 2024 May 7;19(5):e0292766. doi: 10.1371/journal.pone.0292766. eCollection 2024.

DOI:10.1371/journal.pone.0292766
PMID:38713705
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11075863/
Abstract

A child born in developing countries has a 10 times higher mortality risk compared to one born in developed countries. Uganda still struggles with a high neonatal mortality rate at 27/1000 live births. Majority of these death occur in the community when children are under the sole care of their parents and guardian. Lack of knowledge in new born care, inappropriate new born care practices are some of the contributors to neonatal mortality in Uganda. Little is known about parent/caregivers' knowledge, practices and what influences these practices while caring for the newborns. We systematically studied and documented newborn care knowledge, practices and associated factors among parents and care givers. To assess new born care knowledge, practices and associated factors among parents and care givers attending MRRH. We carried out a quantitative cross section methods study among caregivers of children from birth to six weeks of life attending a regional referral hospital in south western Uganda. Using pretested structured questionnaires, data was collected about care givers' new born care knowledge, practices and the associated factors. Data analysis was done using Stata version 17.0. We interviewed 370 caregivers, majority of whom were the biological mothers at 86%. Mean age was 26 years, 14% were unemployed and 74% had monthly earning below the poverty line. Mothers had a high antenatal care attendance of 97.6% and 96.2% of the deliveries were at a health facility Care givers had variant knowledge of essential newborn care with associated incorrect practices. Majority (84.6%) of the respondents reported obliviousness to putting anything in the babies' eyes at birth, however, breastmilk, water and saliva were reportedly put in the babies' eyes at birth by some caregivers. Hand washing was not practiced at all in 16.2% of the caregivers before handling the newborn. About 7.4% of the new borns received a bath within 24 hours of delivery and 19% reported use of herbs. Caregivers practiced adequate thermal care 87%. Cord care practices were inappropriate in 36.5%. Only 21% of the respondents reported initiation of breast feeding within 1 hour of birth, Prelacteal feeds were given by 37.6% of the care givers, water being the commonest prelacteal feed followed by cow's milk at 40.4 and 18.4% respectively. Majority of the respondents had below average knowledge about danger signs in the newborn where 63% and mean score for knowledge about danger signs was 44%. Caretaker's age and relationship with the newborn were found to have a statistically significant associated to knowledge of danger signs in the newborn baby. There are variable incorrect practices in the essential new born care and low knowledge and awareness of danger signs among caregivers of newborn babies. There is high health center deliveries and antenatal care attendance among the respondents could be used as an opportunity to increase caregiver awareness about the inappropriate practices in essential newborn care and the danger signs in a newborn.

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acfc/11075863/98e648a93015/pone.0292766.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acfc/11075863/656740127833/pone.0292766.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acfc/11075863/98e648a93015/pone.0292766.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acfc/11075863/656740127833/pone.0292766.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acfc/11075863/98e648a93015/pone.0292766.g002.jpg
摘要

在发展中国家出生的儿童的死亡率比在发达国家出生的儿童高 10 倍。乌干达的新生儿死亡率仍然很高,为每 1000 例活产中有 27 例。这些死亡大多数发生在社区,当儿童完全由父母和监护人照顾时。缺乏新生儿护理知识、不适当的新生儿护理做法是乌干达新生儿死亡的一些原因。父母/照顾者在照顾新生儿时的知识、做法以及影响这些做法的因素知之甚少。我们系统地研究和记录了父母和照顾者的新生儿护理知识、做法和相关因素。评估在乌干达西南部一家地区转诊医院就诊的出生至六周龄儿童的父母和照顾者的新生儿护理知识、做法和相关因素。我们对在区域转诊医院就诊的 6 周龄以下儿童的照顾者进行了定量横断面方法研究。使用预先测试的结构化问卷收集了关于照顾者新生儿护理知识、做法和相关因素的数据。使用 Stata 版本 17.0 进行数据分析。我们采访了 370 名照顾者,其中大多数是 86%的亲生母亲。平均年龄为 26 岁,14%失业,74%月收入低于贫困线。母亲有很高的产前护理出勤率,为 97.6%,96.2%的分娩是在卫生机构进行的。照顾者对基本新生儿护理的知识各不相同,且与不正确的做法有关。大多数(84.6%)受访者表示,他们在出生时不知道要在婴儿的眼睛里放任何东西,但有些照顾者表示,他们在婴儿出生时在婴儿的眼睛里放了母乳、水和唾液。在 16.2%的照顾者中,完全没有在处理新生儿之前洗手。约 7.4%的新生儿在分娩后 24 小时内洗澡,19%的人报告使用草药。87%的照顾者进行了适当的热护理。脐带护理方法不当,占 36.5%。只有 21%的受访者报告在出生后 1 小时内开始母乳喂养,37.6%的照顾者给予了开奶前喂养,最常见的开奶前喂养是水,其次是牛奶,分别占 40.4%和 18.4%。大多数受访者对新生儿的危险信号的知识平均低于平均水平,其中 63%和对新生儿危险信号知识的平均得分是 44%。照顾者的年龄和与新生儿的关系被发现与新生儿危险信号的知识有统计学显著相关。在基本新生儿护理中存在不同的不正确做法,以及照顾者对新生儿危险信号的认识和意识较低。受访者中有很高的中心分娩和产前护理参与率,这可以作为一个机会,提高照顾者对基本新生儿护理中不当做法和新生儿危险信号的认识。

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