Maternal awareness of newborn danger signs before discharge: a secondary analysis of baseline data from a
Businge Alinaitwe1, Francis Nkunzimaana2, Charles Kato3
1Department of Nursing, College of Health Sciences, Makerere University, Kampala, Uganda. busingebruceali@gmail.com.
Insights
Maternal awareness of newborn danger signs (NDS) is poor in Uganda, with only 14% of mothers recognizing 3 or more signs. This highlights a critical gap in recognizing infant health risks and seeking timely care.
Area of Science:
- Neonatal Health
- Maternal Education
- Public Health in Low-Income Settings
Background:
- The neonatal period is critical, with nearly half of under-5 deaths occurring in the first 28 days.
- Maternal awareness of newborn danger signs (NDS) is crucial for timely care-seeking and improved infant outcomes.
- Evidence on maternal awareness of NDS immediately postpartum is limited in Uganda.
Purpose of the Study:
- To assess the level of maternal awareness of NDS before hospital discharge.
- To identify factors associated with maternal awareness of NDS in the immediate postpartum period in Uganda.
Main Methods:
- Secondary analysis of baseline data from a maternal education intervention in Eastern Uganda.
- Maternal awareness assessed via spontaneous recall of NDS; good awareness defined as ≥3 mentioned signs.
- Binary logistic regression used to determine factors associated with NDS awareness.
Main Results:
- Only 14.0% of 250 postnatal women demonstrated good awareness of NDS.
- Fever and poor breastfeeding were most recognized; hypothermia, cord sepsis, pustules, and convulsions were least recognized.
- Mode of delivery and maternal age were significantly associated with NDS awareness.
Conclusions:
- Maternal awareness of NDS is alarmingly low in the immediate postpartum period.
- Low awareness risks undetected NDS, delayed care-seeking, and adverse infant outcomes.
- Targeted postnatal education is needed, with special attention to younger mothers and those with cesarean deliveries.
Background:
The neonatal period is the most vulnerable time for children under 5 years. Neonatal mortality contributes to almost one-half of all under-5 deaths. Developing one or more newborn danger signs increases the mortality risk in the first 28 days of life. Understanding maternal awareness of newborn danger signs is essential in promoting early newborn care-seeking for better outcomes. In Uganda, there is a paucity of evidence on maternal awareness of newborn danger signs (NDS) immediately after delivery. This study aimed to determine the level and factors associated with maternal awareness of NDS before discharge from the hospital.
Methods:
This is a secondary analysis of baseline data from a hospital-based enhanced maternal education intervention conducted at a Tertiary Care and Teaching Hospital in Eastern Uganda. Maternal awareness of NDS was assessed by recording spontaneous maternal responses to the question, 'What are the danger signs of a newborn baby that you know? Women who mentioned ≥ 3 NDS were categorized as having a good awareness. Frequencies and percentages for all categorical variables were presented in tables and charts. Binary logistic regression analysis was used to determine the factors associated with awareness of NDS.
Results:
The baseline survey enrolled 250 post-natal women. Only 14.0% of the participants had a good awareness of NDS. High body temperature/fever (73.6%) and poor breastfeeding/or failure to breastfeed (38.8%) were the commonly identified NDS. Hypothermia, cord sepsis (0.4%), skin pustules (1.6%), and convulsions (4.6%) were the least identified NDS. Mode of delivery (p = 0.039) and maternal age (p = 0.032) were significantly associated with maternal awareness of NDS.
Conclusions:
Maternal awareness of newborn danger signs in the immediate post-delivery period is poor. The women do not know the majority of the NDS, and therefore, these signs can go undetected, delaying care-seeking and posing a risk for poor infant outcomes. Routine postnatal health education should focus on these danger signs while ensuring that younger mothers and women who deliver by cesarean section are given special attention during knowledge enhancement sessions.
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