Pattern and predictors of maternal care-seeking practices for severe neonatal jaundice in Nigeria: a multi-centre survey

BMC Health Services Research

Bolajoko O Olusanya⁴  Ekanem N Ekure¹  Mariya Mukhtar-Yola²  Rosemary O Ugwu³  Chinyere V Ezeaka¹ 

[1] Department of Paediatrics, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria;Department of Paediatrics, National Hospital, Abuja, Nigeria;Department of Paediatrics and Child Health, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria;Centre for Healthy Start Initiative, Dolphin Estate, Ikoyi, Lagos, Nigeria

关键词: Developing countries;    Self-medication;    Haemolytic agents;    Health promotion;    Health-seeking behaviour;    Newborn care;    Neonatal jaundice;   

Others  :  1132638
DOI  :  10.1186/1472-6963-14-192

 received in 2013-05-28, accepted in 2014-04-25,  发布年份 2014

【 摘 要 】

Background

Nigeria is frequently associated with disproportionately high rates of severe neonatal jaundice (NNJ) underpinned by widespread Glucose-6-phosphate dehydrogenase (G6PD) deficiency. Timely and appropriate treatment of NNJ is crucial for preventing the associated morbidity and neuro-developmental sequelae. Since mothers are likely to be the first mostly to observe the onset of severe illness in their newborns, we set out to identify the pattern and predictors of maternal care-seeking practices for NNJ in three culturally-distinct settings in Nigeria.

Methods

A multi-centre study was conducted among women attending antenatal clinics in Abuja, Lagos and Port Harcourt from October 2011 to April 2012 using a pretested questionnaire. Predictors of awareness of NNJ, accurate recognition of NNJ, use of potentially harmful therapies and preference for future hospital treatment were determined with multivariate logistic regressions.

Results

Of the 488 participants drawn from the three locations, 431 (88.3%) reported awareness of NNJ, predominantly (57.8%) attributable to professional health workers. A total of 309 (63.3%) mothers with prior knowledge of NNJ claimed they could recognise NNJ, but 270 (87.4%) from this group accurately identified the features of NNJ. Multiparous mothers (Adjusted odds ratio, AOR:4.05; 95% CI:1.75-9.36), those with tertiary education (AOR:1.91; CI:1.01-3.61), and those residing in Lagos (AOR:2.96; CI:1.10-7.97) were more likely to have had prior knowledge of NNJ. Similarly, multiparous mothers (AOR:2.38; CI:1.27-4.46) and those with tertiary education (AOR:1.92; CI:1.21-3.05) were more likely to recognise an infant with jaundice accurately. Mothers educated by health workers were 40% less likely to resort to potentially harmful treatment for NNJ (AOR:0.60; CI:0.39-0.92) but more likely to seek hospital treatment in future for an infant suspected with jaundice (AOR:1.88; CI:1.20-2.95).

Conclusions

Women with tertiary education and multiparous mothers who attend routine antenatal clinics are more likely than less educated women, to be associated with appropriate care-seeking practices for infants with NNJ regardless of the socio-cultural setting. Systematic efforts by professional health workers are warranted, as part of routine antenatal care, to engage other groups of mothers especially those likely to indulge in self-use of potentially harmful therapies.

【 授权许可】

   
2014 Ezeaka et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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