title: Newborn care practices at home and in health facilities in 4 regions of Ethiopia.
abstract: BACKGROUND
  Ethiopia is one of the ten countries with the highest number of neonatal deaths globally, and only 1 in 10 women deliver with a skilled attendant. Promotion of essential newborn care practices is one strategy for improving newborn health outcomes that can be delivered in communities as well as facilities. This article describes newborn care practices reported by recently-delivered women (RDWs) in four regions of Ethiopia.
  
  
  METHODS
  We conducted a household survey with two-stage cluster sampling to assess newborn care practices among women who delivered a live baby in the period 1 to 7 months prior to data collection.
  
  
  RESULTS
  The majority of women made one antenatal care (ANC) visit to a health facility, although less than half made four or more visits and women were most likely to deliver their babies at home. About one-fifth of RDWs in this survey had contact with Health Extension Workers (HEWS) during ANC, but nurse/midwives were the most common providers, and few women had postnatal contact with any health provider. Common beneficial newborn care practices included exclusive breastfeeding (87.6%), wrapping the baby before delivery of the placenta (82.3%), and dry cord care (65.2%). Practices contrary to WHO recommendations that were reported in this population of recent mothers include bathing during the first 24 hours of life (74.7%), application of butter and other substances to the cord (19.9%), and discarding of colostrum milk (44.5%). The results suggest that there are not large differences for most essential newborn care indicators between facility and home deliveries, with the exception of delayed bathing and skin-to-skin care.
  
  
  CONCLUSIONS
  Improving newborn care and newborn health outcomes in Ethiopia will likely require a multifaceted approach. Given low facility delivery rates, community-based promotion of preventive newborn care practices, which has been effective in other settings, is an important strategy. For this strategy to be successful, the coverage of counseling delivered by HEWs and other community volunteers should be increased.
authors.affiliation: International Center for Maternal and Newborn Health, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. jcallagh@jhsph.edu.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Callaghan-Koru
authors.forename: Abiy
authors.initials: A
authors.lastname: Seifu
authors.forename: Maya
authors.initials: M
authors.lastname: Tholandi
authors.forename: Joseph
authors.initials: J
authors.lastname: de Graft-Johnson
authors.forename: Ephrem
authors.initials: E
authors.lastname: Daniel
authors.forename: Barbara
authors.initials: B
authors.lastname: Rawlins
authors.forename: Bogale
authors.initials: B
authors.lastname: Worku
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
mesh_terms: D000328:Adult; D000488:Allied Health Personnel; D001942:Breast Feeding / Q000706:statistics & numerical data; D003469:Culture; D036861:Delivery, Obstetric / Q000379:methods; D005002:Ethiopia; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006700:Home Childbirth / Q000706:statistics & numerical data; D006701:Home Nursing / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D007224:Infant Care / Q000379:methods* / Q000706:statistics & numerical data; D007226:Infant Mortality; D007231:Infant, Newborn; D060127:Kangaroo-Mother Care Method / Q000706:statistics & numerical data; D008427:Maternal Health Services / Q000706:statistics & numerical data; D008880:Midwifery; D009035:Mothers / Q000523:psychology; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult