Umbilical Cord Care Knowledge and Practice: What is the Status of National Chlorhexidine Gel Scale-Up in Nnewi Nigeria?

Abstract

Background: Use of chlorhexidine gel for cord care was scaled up in Nigeria to address the high burden of neonatal deaths from severe sepsis but there is scarcity of data on its uptake. Aim: A cross-sectional study was conducted to examine the cord care practices of mothers in Nnewi. Methods: Data was obtained using an interviewer-administered semi-structured questionnaire, and analyzed with SPSS version 21. P-value < 0.05 was considered statistically significant.  Results: Mean age of the 214 studied mothers was 29.6 ± 5.53 years.  Majority had at least secondary education (93.5%), were income earners (83.2%), attended ante-natal clinic (ANC) (83.1%) or delivered (81.8%) in a health facility with skilled provider, and received health education on cord care during pregnancy for the index baby (80.4%). Health education was mostly received during ANC (75.6%[130/172]) and from nurses (73.3%[126/172]). Majority knew about methylated spirit use (89.3%) and the consequence of poor cord care (75.7%) but only 2.8% were aware of chlorhexidine gel use. Umbilical stump was commonly cleaned with methylated spirit (89.3%) and or hot compress (24.8%). Thereafter, 47.7% applied nothing while others applied petroleum jelly (33.2%), toothpaste (8.9%), dusting powder (3.3%) etc. Reasons given for adopting a particular practice included efficacy (54.7%), advice by people (25.7%), peer’s influence (8.4%) and convenience (8.4%).  Factors significantly associated with using an antiseptic agent for cord care were maternal age, educational level, access to or source of health education, and frequency of ANC visits. Conclusion/Recommendation: Respondents demonstrated good knowledge and practice of standard cord care but awareness and use of chlorhexidine gel was almost non-existent. . Hindrances to effective national chlorhexidine scale-up should be identified and addressed. There’s serious need for enlightenment campaigns on chlorhexidine efficacy using public media channels such as radio jingles.