title: Roles and responsibilities in newborn care in four African sites.
abstract: OBJECTIVE
  To explore roles and responsibilities in newborn care in the intra- and postpartum period in Nigeria, Tanzania and Ethiopia.
  
  
  METHODS
  Qualitative data were collected using in-depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses.
  
  
  RESULTS
  We found that birth attendants were the main decision-makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first-time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision-maker in the family.
  
  
  CONCLUSIONS
  Interventions should move beyond a focus on the mother-child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change.
authors.affiliation: Department of Community Medicine, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: R
authors.initials: R
authors.lastname: Iganus
authors.affiliation: Institute of Global Health, University College London, London, UK.
authors.forename: Z
authors.initials: Z
authors.lastname: Hill
authors.affiliation: Ifakara Health Institute, Dar es Salaam, Tanzania.
authors.forename: F
authors.initials: F
authors.lastname: Manzi
authors.affiliation: Institute of Global Health, University College London, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Bee
authors.affiliation: Consultancy for Social Development, Addis Ababa, Ethiopia.
authors.forename: Y
authors.initials: Y
authors.lastname: Amare
authors.affiliation: Ifakara Health Institute, Dar es Salaam, Tanzania.
authors.forename: D
authors.initials: D
authors.lastname: Shamba
authors.affiliation: Post-Graduate School, Lead City University, Ibadan, Nigeria.
authors.forename: A
authors.initials: A
authors.lastname: Odebiyi
authors.affiliation: Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-ife, Nigeria.
authors.forename: E
authors.initials: E
authors.lastname: Adejuyigbe
authors.affiliation: Department of Community Medicine, College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria.
authors.forename: B
authors.initials: B
authors.lastname: Omotara
authors.affiliation: Institute of Global Health, University College London, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Skordis-Worrall
mesh_terms: D002662:Child Health Services / Q000458:organization & administration; D003657:Decision Making; D005002:Ethiopia; D005260:Female; D006801:Humans; D007224:Infant Care / Q000458:organization & administration; D007231:Infant, Newborn; D008297:Male; D008880:Midwifery / Q000458:organization & administration; D009549:Nigeria; D018743:Perinatal Care / Q000458:organization & administration; D011247:Pregnancy; D036301:Qualitative Research; D013636:Tanzania; D013997:Time Factors; D000078329:Workforce
keywords: Africa; Afrique; Newborn; atención inmediata del recién nacido; behaviour; comportamiento; comportement; immediate newborn care; neonatal; nouveau-nés; néonatal; recién nacido; roles; rôles; soins immédiats du nouveau-né; África