Background: Most neonatal deaths occur in Sub-Saharan Africa (SSA) and South Asia. This is particularly true in West Africa. The World Health Organization recommends newborn care practices as a standard of care to improve neonatal mortality.
Objective: To examine the association between delivery location and early newborn care in three West African countries, Nigeria, Senegal, and Benin.
Design/Methodology: This as a secondary analysis of cross-sectional data from the Continuous Demographic and Health Survey in Nigeria (2013), Benin (2017), and Senegal (2017). The study included data on a total of 30269 women with live births in the three years preceding the survey (Benin, n=7239; Nigeria, n=16504; and Senegal, n=6526). The main exposure was delivery location (home, public hospitals, public clinics or health centers, private hospitals and clinics)
We assessed three outcomes: 1) early initiation of breastfeeding, 2) breastfeeding support, and 3) cord examination. We used multivariable logistic regression to estimate the odds ratios and 95% confidence intervals of early newborn care after adjusting for potential confounders.
Results: The prevalence of newborn care practices was higher in Senegal and Benin as compared to Nigeria. Early initiation of breastfeeding was significantly higher in facility deliveries as compared to home births except for Benin. Consistent across all three countries was the positive association between facility delivery and breastfeeding support, and cord examination
Conclusion: Although facility delivery is associated with greater odds of newborn care practices, the prevalence these newborn care practices was suboptimal across all three countries. This presents a missed opportunity to improve neonatal outcomes. Interventions addressing facility delivery are poised to reduce adverse birth outcomes. More qualitative research is needed to explore the suboptimal levels of newborn care practices in the West African sub-region.
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Abstract
Background: Most neonatal deaths occur in Sub-Saharan Africa (SSA) and South Asia. This is particularly true in West Africa. The World Health Organization recommends newborn care practices as a standard of care to improve neonatal mortality.
Objective: To examine the association between delivery location and early newborn care in three West African countries, Nigeria, Senegal, and Benin.
Design/Methodology: This as a secondary analysis of cross-sectional data from the Continuous Demographic and Health Survey in Nigeria (2013), Benin (2017), and Senegal (2017). The study included data on a total of 30269 women with live births in the three years preceding the survey (Benin, n=7239; Nigeria, n=16504; and Senegal, n=6526). The main exposure was delivery location (home, public hospitals, public clinics or health centers, private hospitals and clinics)
We assessed three outcomes: 1) early initiation of breastfeeding, 2) breastfeeding support, and 3) cord examination. We used multivariable logistic regression to estimate the odds ratios and 95% confidence intervals of early newborn care after adjusting for potential confounders.
Results: The prevalence of newborn care practices was higher in Senegal and Benin as compared to Nigeria. Early initiation of breastfeeding was significantly higher in facility deliveries as compared to home births except for Benin. Consistent across all three countries was the positive association between facility delivery and breastfeeding support, and cord examination
Conclusion: Although facility delivery is associated with greater odds of newborn care practices, the prevalence these newborn care practices was suboptimal across all three countries. This presents a missed opportunity to improve neonatal outcomes. Interventions addressing facility delivery are poised to reduce adverse birth outcomes. More qualitative research is needed to explore the suboptimal levels of newborn care practices in the West African sub-region.