Household knowledge and practices of newborn and maternal health in Haripur district, Pakistan.
OBJECTIVE
To learn about household maternal and newborn health knowledge and practices to aid the design of newborn programming within Save the Children's Haripur Program.


METHODS
In April, we conducted 43 semi-structured interviews (SSIs) and 34 focus group discussions among men, women of reproductive age and health service providers; in September, we added 21 SSIs among new mothers, new fathers and dais. Two investigators analyzed the findings according to themes within six care types: antenatal, delivery, immediate newborn, routine postpartum, special maternal and special newborn.


RESULTS
Findings indicated poor maternal diet and antenatal care-seeking. Home delivery with an untrained dai was the norm. Respondents knew about benefits of clean delivery, but rarely put knowledge into practice. Knowledge and practices for maintaining the newborn's warmth were good. Delayed initiation of breastfeeding, avoidance of colostrum and prelacteal feeding were almost universal. Unhygienic cord care, including an unclean cut and application of ghee on the cord-stump, was the norm. After delivery, mothers often maintained low fluid intake but otherwise reported healthy nutritional practices. Knowledge of some danger signs in newborns was common, but timely action upon recognition was not.


CONCLUSIONS
Although the findings illustrate some beneficial practices, many reported practices are harmful to the newborn. These findings, consistent with the sparse existing data in Pakistan, inform program interventions for household-level behavioral change.
Khadduri
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Independent Health Consultant, formerly of Save the Children-US, Islamabad, Pakistan. rkhadduri@yahoo.com
Marsh
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DR
Rasmussen
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B
Bari
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A
Nazir
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R
Darmstadt
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D000328:Adult; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology*; D005220:Fathers; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007224:Infant Care; D007231:Infant, Newborn; D007407:Interviews as Topic; D008297:Male; D008429:Maternal Welfare / Q000208:ethnology*; D008880:Midwifery; D009035:Mothers; D010154:Pakistan; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care