Assessing Maternal Adherence to WHO's Essential Newborn Care Practices in Libo Kemekem District: A Community-Based Study

Background. Around half of child deaths that occur before the age of 5 are related to newborn-related causes. The advice on caring for newborns may not always match with local traditions and beliefs. That's why it's important to understand the current newborn care practices and what influences them. This will help implement efforts to reduce newborn deaths. The goal of this research was to assess essential newborn care practices and the factors associated with them among women who have recently given birth. Methods. A community-based cross-sectional study was conducted in Libo Kemekem District from April 1 to May 1, 2021, among 601 women. Face-to-face interviews using a structured questionnaire were employed for data collection. The completeness of the questionnaires was checked, and errors were manually corrected. The data was then entered into EpiData v3.1 and transferred to SPSS v26.0 for analysis. Descriptive statistics were used to calculate frequencies, percentages, means, and standard deviations of the findings. Bivariate and multivariate analyses were performed to assess the association between variables for early newborn care practices (ENCP). In the bivariable models, independent variables that showed a statistically significant relationship at a P-value less than .2 with the outcome variable were considered candidates for the multivariable logistic regression models. In the multivariate regression, a P-value < .05 was considered statistically significant. Results were presented in text, tables, and graphs. Additionally, we checked for multicollinearity and performed the Hosmer and Lemeshow goodness-of-fit test to ensure the validity of the multivariate logistic regression analysis. Result. The study revealed that 54.2% (95% CI, 50%-58%) of mothers practiced comprehensive ENBC. In the multivariable binary logistic regression analysis, several factors were found to be significantly associated with ENBC. Primary education was associated with a reduced likelihood of practicing essential newborn care, with an adjusted odds ratio (AOR) of 0.34 (95% CI: 0.23-0.78). Similarly, secondary education was also associated with a reduced likelihood, with an AOR of 0.51 (95% CI: 0.34-0.89). On the other hand, mass media exposure was associated with an increased likelihood of practicing essential newborn care, with an AOR of 2.03 (95% CI: 1.35-3.07). The number of ANC visits was also a significant factor, with an AOR of 0.403 (95% CI: 0.237-0.686. Furthermore, knowledge about ENBC and newborn danger signs were both important predictors, with AORs of 3.93 (95% CI: 2.09-7.37) and 0.31 (95% CI: 0.12-0.74), respectively. Conclusion. This study reveals a critically low level of essential newborn care practices in the local community, influenced by education, mass media exposure, ANC visits, mothers' knowledge, and awareness of newborn danger signs. Addressing these factors through targeted interventions can reduce neonatal mortality rates, emphasizing the need for investments in education, health literacy programs, and healthcare services to enhance mothers' and newborns' health outcomes.