Delele Tadesse Guadu, Persson Lars Åke, Schellenberg Joanna, Berhanu Della, Lemma Seblewengel, Defar Atkure, Zemedu Theodros Getachew, Taye Girum, Shiferaw Solomon, Denu Zewditu Abdissa, Tariku Amare, Zelalem Meseret, Gelaye Kassahun Alemu
Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
BMC Pediatr. 2025 Apr 9;25(1):281. doi: 10.1186/s12887-025-05645-1.
Essential newborn care is a set of measures every newborn baby needs, regardless of its birthplace. Geographic equity in essential newborn care refers to the fairness of access to newborn care across different regions. These practices vary across different social groups, but evidence on the geographic equity of newborn care in Ethiopia is scarce. We aimed to assess the geographic distribution and equity of selected essential newborn care practices (initial skin-to-skin care, delayed bathing, proper cord care, timely breastfeeding initiation, and immunizations of BCG and first-dose polio vaccines) recommended by the World Health Organization among neonates born at health facilities and homes in Ethiopia.
We analyzed cross-sectional survey data from 2,493 neonates in the Performance Monitoring for Action (PMA) Ethiopia 2019-2020 survey in five regions and the Addis Ababa City Administration. The survey employed a cross-sectional study design, and the data were collected from 2019 to 2020. We studied the geographic variation of selected essential newborn care practices using Global Moran's I statistics and hot and cold spot analysis (Local Getis-Ord Gi* statistic), and the coverage of these practices were predicted for the whole country using Kriging interpolation.
This study showed that selected essential newborn care practices were higher among neonates in health facilities, those born in Central, Northern, Southern, and a few areas in Southwest and Northwest Ethiopia. Geographic inequities were demonstrated in delayed bathing in facility and home births, proper cord care in facility births, and first immunizations in both facility and home births. Geographic inequities were not observed for initial skin-to-skin care and timely breastfeeding initiation.
Selected essential newborn care practices were higher among neonates born in health facilities, and the recommended essential newborn care practices were higher in Central and Northern Ethiopia. There were geographic inequities in delayed bathing and immunizations of BCG and first-dose polio vaccines among neonates born in health facilities and homes. Enhancing facility delivery, availing first vaccinations in facilities, and improving discharge counseling for mothers during antenatal, delivery, and postnatal care are crucial to ensuring geographic equity in essential newborn care in Ethiopia.
基本新生儿护理是每个新生儿都需要的一系列措施，无论其出生地在哪里。基本新生儿护理的地理公平性是指不同地区获得新生儿护理的公平程度。这些做法在不同社会群体中存在差异，但埃塞俄比亚新生儿护理地理公平性的证据很少。我们旨在评估世界卫生组织推荐的选定基本新生儿护理做法（初始皮肤接触护理、延迟沐浴、正确的脐带护理、及时开始母乳喂养以及卡介苗和首剂脊髓灰质炎疫苗接种）在埃塞俄比亚医疗机构和家中出生的新生儿中的地理分布和公平性。
我们分析了2019 - 2020年埃塞俄比亚绩效监测行动（PMA）在五个地区和亚的斯亚贝巴市行政区对2493名新生儿进行的横断面调查数据。该调查采用横断面研究设计，数据于2019年至2020年收集。我们使用全局莫兰指数统计和热点与冷点分析（局部Getis - Ord Gi*统计）研究选定基本新生儿护理做法的地理差异，并使用克里金插值法预测全国这些做法的覆盖率。
本研究表明，在医疗机构出生的新生儿、在埃塞俄比亚中部、北部、南部以及西南部和西北部一些地区出生的新生儿中，选定的基本新生儿护理做法实施率较高。在医疗机构分娩和在家分娩的延迟沐浴、医疗机构分娩的正确脐带护理以及医疗机构和在家分娩的首次免疫接种方面存在地理不公平现象。在初始皮肤接触护理和及时开始母乳喂养方面未观察到地理不公平现象。
在医疗机构出生的新生儿中，选定的基本新生儿护理做法实施率较高，埃塞俄比亚中部和北部推荐的基本新生儿护理做法实施率较高。在医疗机构和家中出生的新生儿中，延迟沐浴以及卡介苗和首剂脊髓灰质炎疫苗接种存在地理不公平现象。提高医疗机构分娩率、在医疗机构提供首次疫苗接种以及在产前、分娩和产后护理期间改善对母亲的出院指导对于确保埃塞俄比亚基本新生儿护理的地理公平性至关重要。
