Hanspria Sharma1, Akhil D Goel2, Mudita Gosain2, Ritvik Amarchand2, Suresh K Kapoor3, Archna Kumar1, Anand Krishnan2
1Department of Development Communication and Extension, Lady Irwin College, New Delhi, India.
2Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
3Centre for Chronic Disease Control, Gurugram, Haryana, India.
Objective: This study assessed the knowledge, practices, and factors related to essential newborn care among mothers in a rural community in northern part of India and test its association with accredited social health activists (ASHAs) visits during antenatal and postnatal care. Methods: The study represents the formative phase of the community intervention trial for reducing neonatal mortality implemented in Ballabgarh block of Faridabad district, Haryana, India. Mothers who delivered within 1–6 months in 2012 in rural Ballabgarh before the interview were interviewed at home for knowledge and practices (KP) related to cord care, breastfeeding, thermal care, baby handling, and healthcare seeking including danger signs and free ambulance services. A KP score of 14 was derived from these domains and a score above 9 was taken as adequate. A logistic regression was used to test the hypothesis that ASHA visits were related to the higher knowledge among mothers when adjusted for other confounders. Results: Of the 1298 mothers, 42.3% (39.7–45.1) did not apply anything on umbilicus; 8.7% (7.3–10.4) were kept in skin-to-skin contact; 65% (62.3–67.6) were exclusively breastfed for 1st month; and 29.7 (27.2–32.3) first bathed their baby within 3 days to. 41% (38.7–44.1) of mothers were rated to have adequate KP. The KP score was significantly less in mothers who delivered at home (adjusted odds ratio [AOR]: 1.78; 95% confidence interval [CI]: 1.22–2.59), or underwent cesarean section (AOR: 1.67; 95% CI: 1.12–2.53) or did not have contact with ASHA (AOR: 1.64; 95% CI: 1.17–2.29). Conclusion: There is a considerable KP gap in the community. Strengthening and scaling up of ASHA visits could prove to be beneficial for modifying high-risk newborn care norms and practices.
Keywords: Accredited social health activist, Caregiver, Health system components, Neonatal, Teatment seeking.