Newborn care practices in urban slums
Journal of Neonatal-Perinatal Medicine, Issue Volume 2, Number 4 / 2009
Newborn care practices in urban slums: Evidence from central India
Siddharth Agarwal1, Vani Sethi1, Karishma Srivastava1, Prabhat K. Jha2, Abdullah H. Baqui3
1Urban Health Resource Centre, New Delhi, India
2Urban Health Resource Centre, Indore, Madhya Pradesh, India
3International Center for Advancing Neonatal Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
One-third of India’s urban population resides in slums and squatters, in extreme poverty conditions. Newborn care is sub-optimal among India’s urban poor, yet scarcely documented. We assessed newborn care practices in 11 urban slums of Indore in Central India. Practices such as clean cord care, thermal care, timely initiation of breastfeeding and exclusive breastfeeding upto neonatal period were enquired from 312 mothers of infants aged 2–4 months. Correlates of these practices were identified using multiple logistic regression. 72.1% births were home births (slum-home: 56.4%, native-village home: 15.7%).
Slum-based traditional birth attendants (sTBAs) conducted 77.3% slum-home births. Skilled assistance during slum-home births was low (7.4%). Clean cord care (22.2%) and thermal care (10.2%) practices were also low. Trained or skilled assistance during slum-home births was positively associated with clean cord care (OR 4.8 CI 1.7–13.6) and thermal care (OR 2.0 CI: 1.1–4.1). Timely initiation of breastfeeding was sub-optimal (50.6%) even in facility births. Exclusive breastfeeding upto neonatal period was higher for mothers counselled on exclusive breastfeeding by a health volunteer during neonatal period (OR 2.3, CI 1.4–3.8).
Following emerge imperative for improving newborn care in urban slums- i) antenatal and postnatal counselling by trained health volunteers, ii) enhancing competence of sTBAs and linking them to affordable facilities and iii) sensitizing and training public health facility staff.