Knowledge And Practices Of Postnatal Mothers On Newborn Care In Tertiary Care Hospital Of Udupi District

Introduction :

Children are the future of any nation. It is well established that the welfare of a child and his future are totally dependent upon the care and attention bestowed upon him before and after birth. Care of the children had always traditionally been the forte of mothers irrespective of education, income and social class differences. The important task of motherhood is to fulfill physical, emotional, social, intellectual and moral needs of children. There is no doubt that a mother plays an important role in this regard.

Available research studies reveals that mothers had average to poor knowledge on new born care^{1, 2} A descriptive study was conducted on “Knowledge, attitude and practice of neonatal care among postnatal mothers in a tertiary care hospital, Neonatal Division, Department of Pediatrics, in South India among 100 postnatal mothers on knowledge on and attitude towards neonatal care and the practices they follow. Findings of the study showed that knowledge of mothers was inadequate in areas of umbilical cord care (35%), thermal care (76%) and vaccine preventable diseases. Nineteen percentages of them still practice oil instillation into nostrils of newborns and 61% of them administer gripe water to their babies. This study indicates that awareness and attitude of postnatal mothers towards neonatal care has lots of lacunae especially in those who belong to the lower socioeconomic status³. Thus the poor knowledge on part of Mothers can lead to disastrous results in the field of care giving. There is scope for improvement by providing better care and health education for antenatal mothers. If the mothers are not acquainted with knowledge pertaining to dangers signs, hygienic practices, feeding, weaning, health and nutrition including growth and behavior of children, it might affect the rearing of their children. Providing timely education in the form of intervention to the mothers could fill these gaps in knowledge of child care. It is necessary to assess the knowledge of mothers who are going to take care of newborn babies. Because for a newborns most frequent caretaker is their own mothers and it is mothers knowledge and practices that the shapes the future of the new born. Thus the present study was undertaken to assess the assess the knowledge of mothers regarding newborn care, find out the practices of mothers regarding newborn care and to find the relationship between knowledge and practice of mothers regarding newborn

Material and Methods :

A descriptive correlational study was carried out in the postnatal wards of selected tertiary care hospital of Udupi district after obtaining the ethical clearance from institutional ethical committee and administrative permission. A convenient sample of 30 mothers was selected for the study. An informed written consent was obtained after assuring the anonymity and confidentiality from the mothers. Three tools were used for data collection. Tool 1: Demographic Proforma, Tool 2: Knowledge questionnaire on newborn care and Tool 3: Practice questionnaire on newborn care. A structured questionnaire in the form of multiple choice questions was developed to determine the knowledge level of postnatal mothers on newborn care. The questionnaire had 20 items. The correct response carried one mark, thus the maximum possible score was 20. The areas included in the tool were breast feeding, baby's normal findings, warmth, infection, danger signs and immunization.

Structured practice questionnaire was developed to determine the practice of postnatal mothers on newborn care. The tool consisted of 20 items. The questionnaire had both positive and negative questions. For the positive questions, answer “yes” carried two points and “No” carried zero points. “Always” carried two points, “Sometimes” carried one point and “Never” carried zero points. For the negative questions “yes” carried zero point, “No” carried two points, “Always” carried zero, “Sometimes” carried one and “Never” carried two points respectively. All the tools were validated, pretested and reliability was established. Tools were translated to Kannada and language validity was established by retranslating the Kannada version of the tool to English. Data was collected in the month of February 2012.

Statistical analysis :

Statistical package for social sciences software (version 16) was used for statistical analysis of raw data

Results

Sample characteristics

The data collected to describe the sample characteristics were age, type of delivery, religion, education, type of family, place of residence, occupation and the newborn characteristics like gestational age of the newborn, age of the newborn, gender of the newborn, birth weight of the newborn. Description is presented in Table 1.

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Figure 1.

Frequency percentage distribution of the sample based on the knowledge on Newborn care

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Figure 2.

Frequency and percentage distribution of mothers based on practice of newborn care

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Table 1

Frequency and percentage distribution of mothers based on demographic characteristics.  n=30

Sample Characteristic	Frequency	Percentage (%)
1. Age in years
21-30	24	80
31-40	6	20
2. Parity
Primipara	16	53.3
Multipara	14	46.7
3. Mode of Delivery
Normal Vaginal delivery	15	50
LSCS	15	50
4. Religion
Hindu	25	83.3
Muslim	3	10.0
Christian	2	6.7
5. Education
Up to Secondary	14	46.7
Pre-University & Diploma	9	30.0
Diploma & Graduate	9	16.7
Post-graduate	5	6.7
6. Type of family
Joint	19	63.3
Nuclear	11	36.7
7. Area of Residence
Urban	13	43.3
Rural	17	56.7
8. Occupation
Housewife	17	56.7
Unskilled & Semiskilled	5	16.7
Middleclass officer & Semi professional	5	16.7
Professional	5	10

The demographic characteristics of newborn baby's shows that 19 (63.3%), were male & 11 (36.7%) were female. Most of the babies 24 (80%) were above 37 weeks of gestation, 16 (53.3%) of the babies weighed above 3000grams at birth & majority, 21 (70%) were below 6 days of age & 9 (30%) were above 7 days.

Discussion :

In the present study majority of mothers had excellent knowledge and practice on newborn care. The findings are supported by a survey study conducted in 2006 which revealed that mothers' knowledge and practices were within good and satisfactory average scores in most of the studied items related to newborn care giving at home except breast feeding⁴. The study findings also revealed that mothers with higher educational status had better knowledge. Similar findings are reported in other studies also⁵. Based on the findings of the study it is concluded that postnatal mothers admitted in tertiary care hospital of Udupi had excellent knowledge on newborn care. As the knowledge increases the practice of mothers on newborn care improves. The knowledge is independent of educational status. So there is need to identify the mothers with low educational status and awareness programme to be implemented at antenatal period itself so that the newborn care can be improved. The setting and sample were selected on convenient basis limits its generalizability. There is need to carry out a large scale study to explore the different practices adopted by the mothers to provide best care to their babies.