Umbilical Cord Care Practices and Incidence of Febrile Illnesses in the First Month of Life among Newborns- A Population Based Study

Abstract

Background: Infection accounts for 13% of the approximately three million newborns deaths that occur globally every year. Poor umbilical cord hygiene in the first week of life is a well documented risk factor that increases the likelihood of neonatal infections. To curb this trend in developing countries, the World health Organization in 2013 enlisted the use of antiseptic solution as an essential medicine for cord care. Aim: This study aims to describe umbilical cord care practices among mothers in Nigeria and its association with development of fever in newborns in the first month of life. Methods: This is a population based descriptive study using nationally representative data from the 2013 edition of the Nigeria Demographic and Health survey (NDHS). For this study, 12113 women aged 15-49 years were randomly selected from households using a stratified two-stage cluster design. Logistic regression and chi-square was used in data analysis. Results: Unhealthy umbilical cord care was practiced by 27.8% of the respondents. The World Health Organization and national policy recommendation of cord care was significantly practiced by older women (P=0.002), literate mothers (P=0.001), mothers with higher educational attainment (P=0.001), mothers in the higher wealth class (P=0.001), those with access to print and electronic media (P=0.001), mother who uses hospital based postnatal check-up (P=0.001) and mothers resident in urban areas (P=0.001). Compared to newborns whose mothers applied nothing to their umbilical stumps, the odds of developing fever in the first month of life was higher in newborns whose mothers applied Oil (OR 1.79 CI 0.39-8.87); Ash (OR 3.37 CI 0.09-29.51); Toothpaste (OR 4.10 CI 1.01-16.68); Animal dung (OR 11.01 CI 1.11-111); and Other concoction (OR 2.58 CI 0.30-22.22) to the umbilical stump and lower in newborns whose mothers applied Methylated spirit or Chlorhexidine solutions (OR 0.68 CI 0.10-5.6) to the umbilical stump. Conclusion: The need for proper hygiene of the umbilical cord using the recommended antiseptic solution must be re-emphasized among health care providers particularly targeting traditional birth attendants in rural settings. Female education and empowerment which has long been designated as one of the child survival strategy and also highlighted in this study as a strong determinant of healthy cord care practices is needed to promote this low cost and highly effective practices amongst mothers.