title: What affects Clean Delivery Kit utilization at birth in Nepal? A qualitative study.
abstract: BACKGROUND
  Infection is one of the biggest causes of maternal and neonatal death in low-income countries. Clean Delivery Kits (CDKs) promote clean delivery and neonatal care. Our qualitative research explores reasons for low CDK utilization, and describes community perceptions of CDKs in Nepal.
  
  
  METHODS
  We conducted 18 focus group discussions and 40 interviews with CDK users and nonusers, service providers, birth attendants, and household decision makers in 6 districts. We also conducted interviews with central level personnel. CDK users were aware of its benefits, and utilization was largely compatible with birth practices. Utilization was prevented by lack of awareness about the benefits and lack of availability. Participants believed that CDKs were for home use.
  
  
  CONCLUSIONS
  Poor promotion of CDK is related to the disjuncture of promoting CDK use, while encouraging institutional deliveries. If CDKs are made available and marketed for use in households and health institutions, utilization may increase.
authors.affiliation: University College London, London, UK joanna.morrison@ucl.ac.uk.
authors.forename: Joanna
authors.initials: J
authors.lastname: Morrison
authors.affiliation: Johns Hopkins Centre for Communication Programs, Baltimore, MD, USA.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jacoby
authors.affiliation: Central Regional Health Directorate-Hetauda, Ministry of Health and Population, Nepal.
authors.forename: Sagar
authors.initials: S
authors.lastname: Ghimire
authors.affiliation: Academy for Education and Development, Washington DC, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Oyloe
mesh_terms: D000328:Adult; D003657:Decision Making; D036861:Delivery, Obstetric; D004864:Equipment and Supplies / Q000382:microbiology*; D005260:Female; D017144:Focus Groups; D006268:Health Facilities; D006700:Home Childbirth; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007407:Interviews as Topic; D008297:Male; D008880:Midwifery; D009390:Nepal; D011247:Pregnancy; D036301:Qualitative Research