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Improving Hygiene in Home Deliveries in Rural Ghana How to Build on Current Attitudes and Practices

Hill, Z; Tawiah-Agyemang, C; Okeyere, E; Manu, A; Fenty, J; Kirkwood, B; (2010) Improving Hygiene in Home Deliveries in Rural Ghana How to Build on Current Attitudes and Practices. PEDIATR INFECT DIS J , 29 (11) 1004 - 1008. 10.1097/INF.0b013e3181f5ddb1.

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Abstract

Introduction: Clean delivery of newborns is a key intervention for reducing infection-related neonatal mortality. Understanding local practices and beliefs is important for designing appropriate interventions. There are few data from Africa. This study explored delivery practices in Ghana to identify behaviors for intervention and to determine behavioral influencers.Methods: Data on the prevalence of clean delivery behaviors, collected through a demographic surveillance system, were analyzed for 2631 women who delivered at home within a 1-year period. Qualitative data on delivery practices were collected through birth narratives, in-depth interviews, and focus groups with recently delivered/pregnant women, traditional birth attendants, grandmothers, and husbands.Results: Most women delivered on a covered surface (79%), had birth attendants who washed their hands (79%), cut the cord with a new blade (98%), and tied it with a new thread (90%). Eight percent of families practiced dry cord care. Families understood the importance of a clean delivery surface and many birth attendants knew the importance of hand-washing. Delivering on an uncovered surface was linked to impromptu deliveries and a belief that a swept floor is clean. Not washing hands was linked to rushing to help the woman, not being provided with soap, forgetfulness, and a belief among some that the babies are born dirty. The frequent application of products to the cord was nearly universal and respondents believed that applying nothing to the cord would have serious negative consequences.Conclusions: Delivery surfaces, hand-washing, and cord cutting and tying appear appropriate for the majority of women. Changing cord care practices is likely to be difficult unless replacement products are provided.

Type: Article
Title: Improving Hygiene in Home Deliveries in Rural Ghana How to Build on Current Attitudes and Practices
DOI: 10.1097/INF.0b013e3181f5ddb1
Keywords: newborn, clean delivery, home visits, hand washing, Ghana, RANDOMIZED CONTROLLED-TRIAL, FORMATIVE RESEARCH INFORM, NEWBORN-CARE PRACTICES, NEONATAL-MORTALITY, SOUTHERN NEPAL, UMBILICAL-CORD, DEVELOPING-COUNTRIES, SYLHET DISTRICT, UTTAR-PRADESH, HEALTH
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
URI: http://discovery.ucl.ac.uk/id/eprint/155019
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