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Thermal care for newborn babies in rural southern Tanzania : a mixed-method study of barriers, facilitators and potential for behaviour change

Shamba, Donat and Schellenberg, Joanna and Hildon, Zoe Jane-Lara and Mashasi, Irene and Penfold, Suzanne and Tanner, Marcel and Marchant, Tanya and Hill, Zelee. (2014) Thermal care for newborn babies in rural southern Tanzania : a mixed-method study of barriers, facilitators and potential for behaviour change. BMC pregnancy and childbirth, Vol. 14 , 267.

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Official URL: http://edoc.unibas.ch/dok/A6319293

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Abstract

Hypothermia contributes to neonatal morbidity and mortality in low-income countries, yet little is known about thermal care practices in rural African settings. We assessed adoption and community acceptability of recommended thermal care practices in rural Tanzania.; A multi-method qualitative study, enhanced with survey data. For the qualitative component we triangulated birth narrative interviews with focus group discussions with mothers and traditional birth attendants. Results were then contrasted to related quantitative data. Qualitative analyses sought to identify themes linked to a) immediately drying and wrapping of the baby; b) bathing practices, including delaying for at least 6 hours and using warm water; c) day to day care such as covering the baby's head, covering the baby; and d) keeping the baby skin-to-skin. Quantitative data (n = 22,243 women) on the thermal care practices relayed by mothers who had delivered in the last year are reported accordingly.; 42% of babies were dried and 27% wrapped within five minutes of birth mainly due to an awareness that this reduced cold. The main reason for delayed wrapping and drying was not attending to the baby until the placenta was delivered. 45% of babies born at a health facility and 19% born at home were bathed six or more hours after birth. The main reason for delayed bathing was health worker advice. The main reason for early bathing believed that the baby is dirty, particularly if the baby had an obvious vernix as this was believed to be sperm. On the other hand, keeping the baby warm and covered day-to-day was considered normal practice. Skin-to-skin care was not a normalised practice, and some respondents wondered if it might be harmful to fragile newborns. Most thermal care behaviours needed improving. Many sub-optimal practices had cultural and symbolic origins. Drying the baby on birth was least symbolically imbued, although resisted by prioritizing of the mothers. Both practical intervention for instance, having more than one attendant to help both mother and baby, and culturally anchored sensitization are recommended.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Malaria Vaccines (Tanner)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Vaccines (Tanner)
UniBasel Contributors:Tanner, Marcel
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:BioMed Central
ISSN:1471-2393
Note:Publication type according to Uni Basel Research Database: Journal article
Language:English
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Last Modified:31 Dec 2015 10:56
Deposited On:05 Dec 2014 09:45

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