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The determinants of essential newborn care for home births in Bangladesh
T Akter1, A Dawson1, D Sibbritt1
1Faculty of Health, University of Technology, Sydney, Building 10, 235-253 Jones St, Ultimo, NSW 2007, Australia.
Insights
Essential newborn care (ENC) practices in Bangladesh are influenced by parental education, antenatal care, and birth attendant skills. Improving these factors can enhance newborn survival rates.
Area of Science:
- Maternal and Child Health
- Public Health
- Demography
Background:
- Essential newborn care (ENC) practices are critical for reducing neonatal mortality, especially in low-resource settings.
- Home births in Bangladesh present unique challenges for implementing consistent ENC practices.
Purpose of the Study:
- To investigate the sociodemographic, antenatal, and delivery care factors associated with essential newborn care (ENC) practices for home-born neonates in Bangladesh.
- To identify key determinants influencing the adoption of six specific ENC practices.
Main Methods:
- Analysis of cross-sectional data from the Bangladesh Demographic and Health Survey, 2011.
- Inclusion of 3190 recent live-born infants delivered at home.
- Application of logistic regression models to determine factors affecting ENC practices.
Main Results:
- Low parental education, limited antenatal care utilization, and absence of skilled birth attendants were significant barriers to ENC practices.
- Higher birth order, younger maternal age at birth, and smaller birth size were also associated with poorer ENC implementation.
- Regional variations notably impacted the coverage of essential newborn care.
Conclusions:
- Significant opportunities exist to enhance ENC practice coverage in Bangladesh.
- Targeted health promotion for parents with lower education and older mothers is recommended.
- Understanding these determinants is crucial for scaling up ENC in low- and middle-income countries.
Objectives:
To examine the association of sociodemographic, antenatal and delivery care factors with the essential newborn care (ENC) practices of neonates born at home in Bangladesh.
Study Design:
This study analyzed data of a cross-sectional survey-the Bangladesh Demographic and Health Survey, 2011.
Methods:
This analysis considered 3190 most recent live-born infants who were delivered at home within three years of the survey. Logistic regression models were used to identify the factors affecting the implementation of six ENC practices, namely using disinfected instruments to cut the umbilical cord, avoidance of application of any substances to the umbilical cord stump, immediate drying and wrapping of newborns, delayed bathing of newborns, and immediate initiation of breastfeeding.
Results:
Factors affecting ENC practices in Bangladesh are low parental education, low utilization of antenatal care services, the absence of skilled birth attendants, smaller size at birth, higher birth order and mother's age at birth. Regional factors also seem to considerably affect ENC practices.
Conclusion:
There is ample scope to improve the coverage of ENC practices in Bangladesh. Health promotion programmes that target parents with low education and older mothers may help to build awareness of ENC practices. This investigation provides insight into the key determinants of ENC practices, which require consideration when scaling up ENC practices in low-income and lower middle-income countries.
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