RESEARCH
Noninstitutional Births and Newborn Care Practices Among Adolescent Mothers in Bangladesh

https://doi.org/10.1111/j.1552-6909.2011.01240.xGet rights and content

ABSTRACT

Objective

To describe home‐based newborn care practices among adolescent mothers in Bangladesh and to identify sociodemographic, antenatal care (ANC), and delivery care factors associated with these practices.

Design

The 2007 Bangladesh Demographic Health Survey, conducted from March 24 to August 11, 2007.

Setting

Selected urban and rural areas of Bangladesh.

Participants

A total of 580 adolescent women (aged 15–19 years) who had ever been married with noninstitutional births and having at least one child younger than 3 years of age.

Methods

Outcomes included complete cord care, complete thermal protection, initiation of early breastfeeding, and postnatal care within 24 hours of birth. Descriptive statistics and multivariate logistic regression methods were employed in analyzing the data.

Results

Only 42.8% and 5.1% newborns received complete cord care and complete thermal protection. Only 44.6% of newborns were breastfed within 1 hour of birth. The proportion of the newborns that received postnatal care within 24 hours of birth was 9%, and of them 11% received care from medically trained providers (MTP). Higher level of maternal education and richest bands of wealth were associated with complete thermal care and postnatal care within 24 hours of birth but not with complete cord care and early breastfeeding. Use of sufficient ANC and assisted births by MTP were significantly associated with several of the newborn care practices.

Conclusions

The association between newborn care practices of the adolescent mothers and sufficient ANC and skilled birth attendance suggest that expanding skilled birth attendance and providing ANC may be an effective strategy to promote essential and preventive newborn care.

Section snippets

Data Sources

We used data from the 2007 Bangladesh Demographic Health Survey (BDHS), conducted by the NIPORT of the Ministry of Health and Family Welfare of Bangladesh from March 24 to August 11, 2007. Data collection procedures for the BDHS were approved by the ORC Macro Institutional Review Board. The BDHS sample was drawn from all Bangladeshi adults who reside in private dwellings. A stratified, multistage cluster sample of 361 Primary Sampling Units (PSUs), 134 in urban areas and 227 in rural areas, was

Complete Cord Care

In the adjusted model, frequency of mass media exposure of watching television regularly (OR=1.5, 95% CI [1.22, 2.93]) was the only sociodemographic factor found to be associated with complete cord care. Complete cord care was associated with receiving sufficient ANC (OR=1.7, 95% CI [1.23, 2.76]) and birth assisted by MTP (OR=1.7, 95% CI [1.11, 2.26]; Table 4).

Complete Thermal Protection

Mothers with secondary educational level (OR=2.5, 95% CI [1.58, 2.68]) and those belonging to the richest quintile index (OR=1.7, 95% CI

Discussion

Findings indicated that only 42.8% of adolescent mothers reported complete cord care practices of their newborn. Sufficient ANC and births assisted by MTP improved complete cord care practices among these adolescent mothers. A study in rural India also reported that ANC and skilled attendances at birth were significantly associated with clean cord care (Baqui et al., 2007). It was expected that ANC visits would have a positive effect on newborn care practices. With adequate counseling during

Conclusions

The majority of the adolescent mothers in Bangladesh with home deliveries practiced many unsafe essential and preventive newborn care behaviors, such as use of untrained attendants, unsafe cord care, and immediate bathing of the baby. Higher levels of maternal education and higher socioeconomic status were associated with complete thermal protection and postnatal care within the recommended time, but not with complete cord care and early breastfeeding. The most promising findings of the present

Acknowledgments

The authors acknowledge the MEASURE DHS for providing the data set and all individuals and institutions in Bangladesh involved in the implementation of the 2007 BDHS.

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