A cross sectional survey of newborn care practices in rural Sindh, Pakistan: Implications for research and policy

Background: Of the annual 4 million neonatal deaths worldwide, approximately three-quarters occur in developing countries. Pakistan contributes 7% of the global neonatal mortality. It is therefore imperative to explore newborn care practices and identify future opportunities for interventions with respect to newborn care in order to reduce the neonatal morbidity and mortality in the Pakistan context

Methods: A cross sectional survey of 1490 mothers was conducted in a rural district of Sindh Province, Pakistan. Newborn care practices of administration of colostrum, feeding of pre lacteals, immediate feeding of newborn, delayed bathing and cord care were studied and association of good newborn care with use of Antenatal care was tested using logistic regression.

Results: Moderate (32%) to high (69%) prevalence of unsafe newborn care practices were observed among study subjects. Uptake of antenatal care services and skilled birth attendance were not common place. Uptake of antenatal care services was identified as a strong predictor of good newborn care after controlling for skilled birth attendance, socio-economic status, age of mother and sex of infant (OR=1.26; CI95%: 1.00-1.57).

Conclusions: The high prevalence of unsafe newborn care practices reported in the present study are consistent with other studies conducted in developing countries, including Pakistan and suggest a need for behavioral changes interventions. Moreover the association of uptake of antenatal care services with good newborn care highlights the necessity to improve coverage of services with the integration of counseling about newborn care in order to reduce the burden of neonatal morbidity and mortality.