Skin, thermal and umbilical cord care practices for neonates in southern, rural Zambia: a qualitative study

BMC Pregnancy and Childbirth

Luke C. Mullany¹  Janneke H. van Dijk⁴  Philip Thuma⁴  Peter J. Winch¹  William J. Moss²  Emma Sacks³ 

[1] Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E5533, Baltimore 21205, MD, USA;Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, E6547, Baltimore 21205, MD, USA;USAID Maternal and Child Survival Program (MCSP)/ICF International, Washington, DC, USA;Macha Research Trust, PO Box 630 166, Choma, Zambia

关键词: Zambia;    Cord care;    Thermal care;    Skin care;    Traditional practices;    Neonatal health;    Newborn health;   

Others  :  1219956
DOI  :  10.1186/s12884-015-0584-2

 received in 2014-07-23, accepted in 2015-07-03,  发布年份 2015

【 摘 要 】

Background

In Choma District, southern Zambia, the neonatal mortality rate is approximately 40 per 1000 live births and, although the rate is decreasing, many deliveries take place outside of formal facilities. Understanding local practices during the postnatal period is essential for optimizing newborn care programs.

Methods

We conducted 36 in-depth interviews, five focus groups and eight observational sessions with recently-delivered women, traditional birth attendants, and clinic and hospital staff from three sites, focusing on skin, thermal and cord care practices for newborns in the home.

Results

Newborns were generally kept warm by application of hats and layers of clothing. While thermal protection is provided for preterm and small newborns, the practice of nighttime bathing with cold water was common. The vernix was considered important for the preterm newborn but dangerous for HIV-exposed infants. Mothers applied various substances to the skin and umbilical cord, with special practices for preterm infants. Applied substances included petroleum jelly, commercial baby lotion, cooking oil and breastmilk. The most common substances applied to the umbilical cord were powders made of roots, burnt gourds or ash. To ward off malevolent spirits, similar powders were reportedly placed directly into dermal incisions, especially in ill children.

Conclusions

Thermal care for newborns is commonly practiced but co-exists with harmful practices. Locally appropriate behavior change interventions should aim to promote chlorhexidine in place of commonly-reported application of harmful substances to the skin and umbilical cord, reduce bathing of newborns at night, and address the immediate bathing of HIV-infected newborns.

【 授权许可】

   
2015 Sacks et al.

【 图 表 】

Fig. 1.

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