Home-based neonatal care by Health Extension Worker in rural Sidama Zone southern Ethiopia: a cross-sectional study

Abstract

Background

Home-based neonatal care is associated with a reduction in neonatal mortality in settings with poor access to health facility-based care. The first day of a child’s life is a day of unparalleled opportunity to spare lives and sets the level for a sound future. The aim of this study was to evaluate the prevalence and timing of home-based neonatal care by health extension workers (HEWs) in the rural Sidama Zone of southern Ethiopia.

Subjects and methods

A community-based, cross-sectional study was conducted, and a total of 2,040 mothers who had a live birth in the last 6 months were studied from 1 to 31 January 2017. Interviewer-administered data were collected using a standard questionnaire developed by the Saving Newborn Lives Program. A descriptive analysis and logistic regression analyses were done.

Results

It was found that 252/2,040 (12.4%) mothers and their neonates were visited by the HEWs during the first month of birth. Out of all households who had a history of visits, 139 (55.2%) had a single visit. Of these, only 66/252 (26.2%) of the first visit were within the first 24 hours. Mothers who received postnatal home visit by the HEWs were at 1.35 times greater odds to have good postnatal practice compared to unvisited mothers (adjusted odds ratio [AOR] 1.35, 95% CI [1, 1.71]). Mothers who gave their last birth at home were 36% less likely to have good postnatal practice compared to those who gave birth in a health institution (AOR 0.64, 95% CI [0.53, 0.79]).

Conclusion

Majority of the neonates did not get the recommended number and frequency of home visits. Postnatal home visit by HEWs had a great role in mothers having good postnatal practice. Therefore, all stakeholders should give attention on strengthening supportive supervision, proper implementation of community-based maternal and neonatal care is very crucial.

Keywords:

• home-based neonatal care
• health extension worker
• rural Sidama
• Ethiopia

Acknowledgments

The authors would like to thank Save the Children and the CHIRT project for providing a budget for this study; the Hawassa University, College of Medicine and Health Science for the opportunity and overall material support; and the Sidama Zone Health Bureau and the five Woreda Health Offices for their support in approving the study. The authors would also like to thank Dr Fistum Weldgebrieal for her constructive comments during first draft write-up. Lastly, the authors would like thank the data collectors and the study participants, without whom this study could not have been conducted.

Author contributions

AG and YH were involved in the conception and design of the study, data collection, data supervision, data processing, cleaning, analysis and interpretation of the results, and developing the manuscript. AA, MT and MM were involved in the conception and design of the study, data collection and data supervision. All authors contributed toward data analysis, drafting and revising the paper, gave final approval of the version to be published, and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.