Newborn care practices at home and health facilities in Tigray, Ethiopia: a qualitative assessment

Abstract

ABSTRACT Background: The neonatal period is the most vulnerable age for child survival. In 2019, about half of all under-five mortality was contributed by the newborn deaths, which was estimated to be about 2.4 million deaths worldwide.1 In Ethiopia, the estimated neonatal mortality rate stands at 33 deaths per 1,000 live births.3 The study will outline newborn care practices both in homes and in the public health care system in Tigray. Methods: The qualitative study employed two data collection methods, namely, focus group discussions and in-depth interviews. The study was conducted in five zones of the Tigray region. In all, 16 focus group discussions and 46 in-depth interviews were held with community representatives and health workers. Data were transcribed and then analyzed using the ATLAS.ti software for thematic coding using an inductive approach. Themes identified were discussed in detail prior to coding. Result: The community perspective shows that there is enough knowledge regarding basic newborn care and harmful traditional practices; however, practices have not been resolved. Active engagement of parents, especially mothers, in facility-based care is socially and economically limited. Health Professionals' Perspective: Weight measurements for home births, as opposed to those in facilities, are not regularly carried out, with many newborn babies not having their weight measured. There are missed home births despite having a home birth notification framework in place. HEWs conduct postnatal care via routine home visits; however, there is weak continuum of care and referral feedback from hospitals. Besides these, widespread shortages of electricity and phototherapy machines and community awareness for care of preterm and LBW babies were noted. Parents' experiences are shaped by the forces of economic insecurity and social issues. Conclusion: The improvement of newborn care practices at home and health facilities is an important milestone that the Ethiopian Federal Ministry of Health is seeking to achieve as it works toward the reduction of the neonatal mortality rate. This feat will be realized at the facility level when actionable strategies, resource commitments, strengthening of the HEP, and health education are implemented.