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      Cord Care Practices: A Perspective of Contemporary African Setting

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          Abstract

          Background

          Cord care is the series of steps applied in handling of the umbilical cord after delivery of the new born. Globally, an estimated 4 million deaths occur annually within the first 4 weeks of life and 1.5 million of these deaths are attributable to infections. In Nigeria, studies have reported umbilical cord infections accounting for between 10 and 19% of neonatal admissions and resultant estimated 30–49% neonatal deaths. Hence, this study was conducted to assess the knowledge and practice of cord care within a contemporary setting.

          Methodology

          This was a cross-sectional study conducted among 324 mothers of children less than 59 months using a multistage sampling technique and SSPS version 20 was used for data analysis. Crude and adjusted odds ratios as well as 95% confidence interval were used in this study with a P-value of ≤0.05 considered statistically significant.

          Results

          The mean age of the mothers in the study was 27.5 ± 6 years with majority of them having good overall knowledge and practice of cord care. Factors such residence in rural community (AOR = 0.26; 95% CI = 0.0915–0.7230) and heath facility delivery (AOR = 7.0; 95% CI = 4.7877–9.3948) were predictors of cord care practices.

          Conclusion

          This study has brought to light the level of cord care practices with health facility delivery, place of residence, and knowledge of cord care as its determinants.

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          Most cited references24

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          Knowledge, practice and associated factors of essential newborn care at home among mothers in Gulomekada District, Eastern Tigray, Ethiopia, 2014

          Background Around the world, more than three million newborns die in their first months of life every year. In Ethiopia during the last five years period; neonatal mortality is 37 deaths per 1000 live births. Even though there is an improvement compared to the past five years, there is still high home delivery 90 %, and high neonatal mortality about the Millennium Development Goal, which aims to be less than 32/1000 live births in Ethiopia. The purpose of this study is to assess maternal knowledge, practice and associated factors of essential newborn care at home in Gulomekada District Eastern Tigray, Ethiopia. Methods A community-based cross-sectional study is conducted in 296 mothers from Gulomekada District by using simple random sampling technique. Data entry and analysis is carried out by using Statistical Package for Social Sciences-20. The magnitude of the association between different variables about the outcome variable is measured by odds ratio with 95 % confidence interval. A binary logistic regression analysis is made to obtain odds ratio and the confidence interval of statistical associations. The goodness of fit had tested by Hosmer-Lemeshow statistic and all variables with P-value greater than 0.05 are fitted to the multivariate model. Variables with P < 0.2 in the bivariate analysis are included in the final model, and statistical significance is declared at P < 0.05. Result Eighty percent (80.4 %) study participants had good knowledge on essential new born care and 92.9 % had the good practice of essential new born care. About 60 % of mothers applied butter or oil on the cord stump for their last baby. Marital status and education are significantly associated with knowledge, whereas urban residence mothers with good knowledge on essential newborn care and employed mothers are significantly associated with mothers’ practice of essential newborn care. Conclusion Almost all mothers know and practice essential newborn care correctly except oil or butter application to the cord stump is highly practiced which should be avoided. Only marital status and educational status are significantly associated with mothers’ knowledge. Electronic supplementary material The online version of this article (doi:10.1186/s12884-016-0931-y) contains supplementary material, which is available to authorized users.
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            Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana

            Background. This study was designed to understand the patterns and determinants of three essential newborn care practices: safe cord care, optimal thermal care, and neonatal feeding practices.Methods. A community-based cross-sectional study was carried out on a sample of 404 lactating mothers who have delivered a live baby at home within the past one year prior to the study.Results. Overall, the prevalence of essential newborn practices on safe cord care and optimal thermal care was exceptionally low. Of the 404 newborns, only 0.2% (1) had safe cord care, 5.2% (21) optimal thermal care, and 50.2% (203) were considered to have had adequate neonatal feeding. In logistic regression analysis, the main predictors of good neonatal feeding were maternal age, timing of the first antenatal care (ANC), and maternal knowledge of newborn danger signs. Women who could mention at least 4 danger signs of the neonate were 4 times more likely to give good neonatal feeding to their babies (AOR = 4.7, Cl: 2.43–9.28),P<0.001.Conclusion. Evidence from this study strongly suggests that the expected essential newborn care practices are not available to a substantial number of the newborns. Efforts should therefore be made by the Ghana Health Service (GHS) to expand essential newborn care interventions beyond institutional level into the communities.
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              Topical umbilical cord care at birth.

              Umbilical cord infection caused many neonatal deaths before aseptic techniques were used. To assess the effects of topical cord care in preventing cord infection, illness and death. We searched the Cochrane Pregnancy and Childbirth Group trials register (September 2003) and the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2003). We also contacted experts in the field. Randomized and quasi-randomized trials of topical cord care compared with no topical care, and comparisons between different forms of care. Two reviewers assessed trial quality and extracted data. Twenty-one studies (8959 participants) were included, the majority of which were from high-income countries. No systemic infections or deaths were observed in any of the studies reviewed. No difference was demonstrated between cords treated with antiseptics compared with dry cord care or placebo. There was a trend to reduced colonization with antibiotics compared to topical antiseptics and no treatment. Antiseptics prolonged the time to cord separation. Use of antiseptics was associated with a reduction in maternal concern about the cord. Good trials in low-income settings are warranted. In high-income settings, there is limited research which has not shown an advantage of antibiotics or antiseptics over simply keeping the cord clean. Quality of evidence is low.
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                Author and article information

                Contributors
                URI : http://frontiersin.org/people/u/304601
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                31 January 2018
                2018
                : 6
                : 10
                Affiliations
                [1] 1Department of Community Medicine, University of Jos , Jos, Nigeria
                [2] 2Department of Community Medicine, Jos University Teaching Hospital , Jos, Nigeria
                [3] 3Department of Paediatrics, University of Jos , Jos, Nigeria
                [4] 4Department of Paediatrics, Jos University Teaching Hospital , Jos, Nigeria
                [5] 5Faculty of Medical Sciences, University of Jos , Jos, Nigeria
                Author notes

                Edited by: Amit Agrawal, Hamidia Hospital, India

                Reviewed by: Paolo Ghirri, University of Pisa, Italy; Jugesh Chhatwal, Christian Medical College & Hospital, India

                *Correspondence: Tolulope O. Afolaranmi, toluene42002@ 123456yahoo.com

                Specialty section: This article was submitted to Child Health and Human Development, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2018.00010
                5797764
                29445723
                6c5f0b7b-5783-4a13-9708-883cbdbab8da
                Copyright © 2018 Afolaranmi, Hassan, Akinyemi, Sule, Malete, Choji and Bello.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 27 September 2017
                : 15 January 2018
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 30, Pages: 6, Words: 0
                Categories
                Public Health
                Original Research

                knowledge,practice,predictors,cord care,african setting
                knowledge, practice, predictors, cord care, african setting

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