Who needs more support from health care workers to take care of the newborn in Sri Lanka?

Background:

Sri Lanka reports the lowest neonatal mortality in South East Asia region, but it has been stagnant for the last decade. Moreover, neonatal morbidity is on the rise. New strategies to further reduce neonatal mortality and improve morbidity statistics should focus on more disadvantaged mothers and areas of low knowledge on newborn care, as these endanger the survival and quality of life of the newborn. Identifying who needs more care on which areas is fundamental in bridging this gap.

Objective:

To assess the knowledge and associated factors on evidence-based interventions on newborn care among postpartum mothers

Methods:

This cross-sectional study was conducted among 422 postpartum mothers with newborn babies in postnatal wards at a tertiary maternity care institution. The participants were interviewed consecutively using a pre-tested questionnaire, which was checked for judgmental validity. Knowledge was assessed on interventions identified by the World Health Organization and UNICEF to improve the survival and quality of life of newborn at the community level. Areas of low knowledge were assessed by the percentage of knowledge scores. Participants were dichotomized into ‘good’ and ‘poor’ levels of knowledge by the median knowledge score. Associations with low level of knowledge were evaluated using univariate as well as multivariate analysis, for which p value of 0.05 was considered as the level of significance.

Results:

Mean age of the mothers was 29.7 (SD=5.6) years. The mean overall knowledge score was 72.7%. Knowledge was poor on interventions related to demand feeding and basic emergency care. Good level of knowledge was associated with having more than one child (p<0.001), secondary education (p<0.001) and attending antenatal parent-educational classes (p=0.002).

Conclusions:

Most mothers possessed good overall knowledge, but knowledge was poor in a few important areas. Mothers of newborn who are primiparous, less educated and do not participate in antenatal parenteducational classes were at higher risk, implying that these mothers need more support from the health staff to avert preventable neonatal morbidities.