rate of decline in neonatal mortality rate is one of the major obstacles in
achieving Millennium Development Goal 4 especially in developing countries.
Even in India, nationwide interventions targeting safe mother and newborn
care have not yielded the desired impact, indicating
the necessity to combat neonatal mortality rate at population specific
level. The objective of this study is to identify the newborn care practices
and beliefs, analyze their harmful or beneficial characteristics, describe the
deviations from the essential newborn care practices during hospital/home
delivery, explain barriers to care seeking and identify areas of potential
resistance for behavior change; and utilize study findings to tailor-make
cost-effective essential newborn care package. The study uses qualitative
data from in-depth interview of mothers who had experienced neonatal death and
key-informant interviews with healthcare personnel and birth attendants. 33
cases were randomly selected from the
registered neonatal deaths across Bharuch district of Gujarat, India. Key
finding of this study is less prevalent practice of essential newborn care
among all cases irrespective of place of delivery and the health-care personnel facilitating delivery. Habitual traditional/tribal
newborn care methods challenge the practice of prescribed essential
newborn care. Clustering of deaths in few households added significantly to the
existing burden of neonatal deaths, attributed to superstition “Ratewa” by tribal. Study has concluded
that the introduction and implementation of essential newborn care at hospital
and community/ household level are the need of the hour. Quality home based
neonatal care through cost effective interventions is deemed necessary where
accessing institutional care is not possible in the immediate term. Community
health workers can contribute to the eradication of harmful newborn care
practices and the sustenance of essential practices through community education and behavior change communication.
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