150442 Newborn Care in Developing Countries: Too Little, Too Late and Unequal

Tuesday, November 6, 2007

Alfredo L. Fort, MD, PhD , Demographic and Health Surveys (DHS), Path/Macro International, Calverton, MD
Monica T. Kothari, MPH , Division of Demographic Health Research, ORC Macro, Calverton, MD
Noureddine Abderrahim, MS , MEASURE DHS, ORC Macro, Calverton, MD
Background. Maternal and Neonatal mortality continue to be high in the developing world. More than two-thirds of newborn deaths occur within the first week after delivery. Yet, there is little information about the occurrence and timing of postnatal care (PNC).

Methods. This study uses data from Demographic and Health Surveys (DHS) conducted in developing countries in the last 5 years. Analyses focus on the postnatal period, up to six weeks after delivery. Data are on occurrence and timing of postnatal care, at times in comparison with mothers' postpartum care, and selected characteristics of mothers and their households.

Findings. About one-half of births occur outside health institutions and approximately 7 in 10 births do not receive PNC. Timing of first care is between two to three days after birth. Newborns who receive postnatal care live in wealthier households, and their mothers had received previous antenatal care, are educated beyond primary level, live in urban areas and have had more media exposure. For some countries, newborn care is received earlier, while mothers' postpartum care is provided later, usually after the first week.

Discussion. Postpartum and postnatal care are still scarcely provided, especially where home deliveries are predominant. Where available, care is generally late to prevent deaths of mothers from postpartum hemorrhage, and of neonates from asphyxia, hypothermia, infections and conditions associated with low birth weight. Increased attendance of delivery or within 2 hours after birth by a trained professional, and upgrading of primary health institutions are advocated.

Learning Objectives:
1. Determine the amount of newborn care and who receives this critical care in developing countries. 2. Use the information received to suggest policies to increase postpartum/postnatal care, especially among the underserved populations.

Keywords: Maternal and Child Health, Developing Countries

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.