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  • Original Article
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Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan

Abstract

Objective:

To learn about household maternal and newborn health knowledge and practices to aid the design of newborn programming within Save the Children's Haripur Program.

Study Design:

In April, we conducted 43 semi-structured interviews (SSIs) and 34 focus group discussions among men, women of reproductive age and health service providers; in September, we added 21 SSIs among new mothers, new fathers and dais. Two investigators analyzed the findings according to themes within six care types: antenatal, delivery, immediate newborn, routine postpartum, special maternal and special newborn.

Result:

Findings indicated poor maternal diet and antenatal care-seeking. Home delivery with an untrained dai was the norm. Respondents knew about benefits of clean delivery, but rarely put knowledge into practice. Knowledge and practices for maintaining the newborn's warmth were good. Delayed initiation of breastfeeding, avoidance of colostrum and prelacteal feeding were almost universal. Unhygienic cord care, including an unclean cut and application of ghee on the cord-stump, was the norm. After delivery, mothers often maintained low fluid intake but otherwise reported healthy nutritional practices. Knowledge of some danger signs in newborns was common, but timely action upon recognition was not.

Conclusion:

Although the findings illustrate some beneficial practices, many reported practices are harmful to the newborn. These findings, consistent with the sparse existing data in Pakistan, inform program interventions for household-level behavioral change.

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References

  1. Pakistan Demographic and Health Survey 2006–07, Preliminary Report. National Institute of Population Studies: Islamabad, Pakistan and MEASURE DHS, Macro International: Maryland, USA.

  2. Lawn JE, Cousens S, Zupan J . 4 million neonatal deaths: when? where? why? Lancet 2005; 365 (9474): 1845, Neonatal Survival March.

    Article  Google Scholar 

  3. Macro International. Pakistan Demographic and Health Survey 1991.

  4. Save the Children USA. Saving Newborns Lives Initiative. State of the World's Newborns. Save the Children USA: Washington, DC, 2001.

  5. Save the Children USA. Saving Newborn Lives Initiative. State of the World's Newborns: Pakistan. Save the Children: Islamabad, 2001.

  6. Bhutta ZA . Newborn care in Pakistan: priorities for research and intervention. Proceedings from 10th National Pediatric Conference, vol. 23. Pakistan Pediatric Association Federal Branch 2001.

  7. Raza SA, Akhtar S, Avan BI, Hamza H, Rahbar MH . A matched case control study of risk factors for neonatal tetanus in Karachi, Pakistan. J Postgrad Med 2004; 50: 247–251.

    CAS  PubMed  Google Scholar 

  8. Bennett J, Macia J, Traverso H, Agha SD, Malooly C, Boring J . Protective effects of topical antimicrobials against neonatal tetanus. Int J Epidemiol 1997; 26: 897–903.

    Article  CAS  Google Scholar 

  9. Zobairi SE, Freitas ML, Wasti SA . Diet and nutrition: a knowledge, attitude, and practice study of pregnant women in Karachi. Aust NZ J Obstet Gynaecol 1998; 38 (2): 188–193.

    Article  CAS  Google Scholar 

  10. Bhardwaj N, Hasan SB . High perinatal and neonatal mortality in rural India. J R Soc Health 1993; 113 (2): 60–63.

    Article  CAS  Google Scholar 

  11. Osrin D, Tumbahangphe KM, Shrestha D, Mesko N, Shrestha D, Manandhar MK et al. Cross sectional, community-based study of care of newborn infants in Nepal. BMJ 2002; 325: 1063.

    Article  Google Scholar 

  12. International Institute for Population Sciences and ORC-Macro. NFHS-II. National Family Health Survey-II. 1989–1999. International Institute for Population Sciences and ORC-Macro: Mumbai, India, 2001.

  13. Bang AT, Bang RA, Reddy HM, Deshmukh MD, Baitule SB . Reduced incidence of neonatal morbidities: effect of home-based neonatal care in rural Gadchiroli, India. J Perinatol 2005; 25: S51–S61.

    Article  Google Scholar 

  14. Bhandari N, Bahl R, Mazumdar S, Martines J, Black R, Bhan M . Effect of community-based promotion of exclusive breastfeeding on diarrhoeal illness and growth: a cluster randomized controlled trial. Lancet 2003; 361 (9367): 1418–1423.

    Article  Google Scholar 

  15. Fikree FF, Rahbar MH, Ali T . Traditional newborn practices in selected low socioeconomic settlements of Karachi, Pakistan. Proceedings from 10th National Pediatric Conference, vol. 23. Pakistan Pediatric Association Federal Branch 2001; 23.

  16. Karim SA, Khurshid M, Memon AM, Jafarey SN . Anemia in pregnancy—its cause in the underprivileged class of Karachi. J Pak Med Assoc 1994; 44: 90–92.

    CAS  PubMed  Google Scholar 

  17. Kazmi S . Pakistan: consumer satisfaction and dissatisfaction with maternal and child health services. World Health Stat Quart 1995; 48: 55–59.

    CAS  Google Scholar 

  18. Hanif H, Najmi RS . A community based knowledge, attitudes, and practice (KAP) survey on the non or improper utilization of maternity services by Pakistani mothers. Specialist 1998; 14: 99–104.

    Google Scholar 

  19. Marsh DR, Sternin M, Khadduri R, Ihsan T, Nazir R, Bari A et al. Identification of model newborn care practices through a positive deviance inquiry to guide behavior-change interventions in Haripur, Pakistan. Food Nutr Bull 2002; 23 (Suppl 4): 109–118.

    PubMed  Google Scholar 

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Acknowledgements

We acknowledge the work of the researchers Amama Ambreen, Irum Fatima and Mohammed Shafique in collecting the data; Naureen Raheel for translating the research findings into English; Munawar Sultana for back-translating a selection of the manuscripts for checking; and Zohra Patel for editorial assistance. We are also grateful to the other members of the Haripur District RH Program, particularly the Administration Department, for their support during the study. This research has been made possible by funding for the Saving Newborn Lives Initiative of the SC through a grant from the Bill & Melinda Gates Foundation and from the Royal Netherlands Embassy for the Haripur District RH Program.

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Correspondence to R Khadduri.

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Khadduri, R., Marsh, D., Rasmussen, B. et al. Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan. J Perinatol 28, 182–187 (2008). https://doi.org/10.1038/sj.jp.7211903

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  • DOI: https://doi.org/10.1038/sj.jp.7211903

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