Community perceptions and practices regarding newborn health in Navrongo, Ghana

Purpose: More than 2 million newborn deaths occur each year in the home, therefore understanding community perceptions of neonatal illness is critical to developing effective neonatal mortality reduction programs. This study explored household beliefs and practices regarding neonatal illness in rural Kassena-Nankani District, Northern Ghana. Methods: 61 in-depth interviews were conducted with 35 women with newborn infants, 13 health care providers and 13 community leaders. Additionally, 18 focus group discussions were conducted among grandmothers, compound heads and mothers. All interviews and focus groups were audiotaped, transcribed into English and imported into NVivo 9.0. Results: Respondents clearly recognized danger signs of illness in the pregnant mother and infant. Responses to that recognition varied, with some respondents suggesting immediate referral to health facilities and others opting for traditional healers, particularly for “we yuu zugah” (convulsions). Traditional practices varied widely for newborns with breathing difficulties, with many respondents applying water or a poultice to the newborn's chest or beating a hoe or implement close to the ear. All respondents knew about the presence of health facilities, and many were aware of the value of preventive care. Husbands were responsible for offering sacrifices and interfacing with sooth-sayers, while grandmothers were the decision-makers regarding facility-based attendance, bathing and praying. Conclusions and implications: Traditional practices surrounding neonatal health in rural Ghana are widespread and do not always match clinical recommendations. Fathers and grandmothers play a pivotal role in the household management of newborn illness and should be included in any program interventions.