International Journal of Health Sciences and Research

Vol.12; Issue: 11; November 2022

Website: www.ijhsr.org
Original Research Article ISSN: 2249-9571

Awareness Regarding Care of Newborn among Post

Natal Mothers in Teaching Hospital Lalitpur
Sangita Panthi1, Manju Nepal2
1
Nursing Officer, Patan Academy of Health Sciences, Patan Hospital, Lagankhel, Nepal
2
Assistant Professor, Patan Academy of Health Sciences, School of Nursing and Midwifery, Lalitpur Nursing
Campus, Nepal

Corresponding Author: Sangita Panthi

DOI: https://doi.org/10.52403/ijhsr.20221128

ABSTRACT

Background: Neonatal period is the critical time for extra uterine adjustment. During this
crucial period of life, they need to provide appropriate care including warmth, normal
breathing, hygiene, skin care, immunization, care of umbilical cord and early exclusive breast
feeding to improve the survival of children. The aim of this study is to identify the level of
awareness regarding care of newborn among post-natal mother in Patan hospital.
Method: A descriptive cross sectional study was conducted among 76 post-natal mothers
using purposive sampling technique. Data was collected between “16th to 29 of January
2022” by using self- developed structure interview questionnaire. The data were analyzed
using SPSS version 20 in descriptive statistic and inferential statistic
Results: The result of the study revealed that 52.6% of respondents had good awareness,
47.4% had poor awareness regarding care of newborn. Majority of respondents had adequate
awareness on exclusive breastfeeding, maintaining hand hygiene, immunization and bathing.
While only 22.4% of respondents were aware about demand feeding and 30.3% aware on
neonatal jaundice. Most of respondents received four times ANC services. There was
significant association between type of family and level of awareness on newborn care where
p value 0.036. However, there was no significant association between age, education,
occupation, and complete ANC visit with awareness on newborn care with p value >0.05 at
5% level of significance.
Conclusion: This study concludes that more than half of respondents’ had adequate level of
awareness. This finding shows that to improve the awareness on newborn care they need an
antenatal education for primi para mother.

Key words: awareness, newborn care, post-natal mother

INTRODUCTION the survival and having healthy children.2,3,

A newborn or neonate is a child under 28 Children are our future and utmost precious
days of age. Neonatal period is the critical resources, after birth health of neonate
time for extra uterine adjustment.1 During depend upon the health care practice
this crucial period of life they need to adopted by family especially mothers.4
provide appropriate care including warmth, Globally 2.4 million children died in the
normal breathing, hygiene, skin care, first month of life in 2020. There are
immunization, care of umbilical cord, early approximately 1 million newborn deaths
exclusive breast feeding, to improve both first 24 hours birth day. The proportion

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Sangita Panthi et.al. Awareness regarding care of newborn among post natal mothers in Teaching Hospital
Lalitpur

death rate of neonate in among the under of the neonates (56%) died at home. During
five children was 47% of all child deaths in neonatal period early exclusive breast
under five children and about one third feeding and hypothermia management could
dying on the day of birth and close to three prevent 70% of current neonatal death
quarters dying within the first week of life. 2 through the essential newborn care.7
The most common causes of neonatal deaths According to study conducted at BPKIHS,
worldwide are preterm birth, intra-partum- on knowledge regarding care of newborn
related complications (birth asphyxia or lack which found that 95% knew about the
of breathing at birth), infections and birth immunization whereas only 1.5% knew
defects. Given that most of these deaths can about cord care, 44.6% knew about
be easily prevented or treated with cheap breastfeeding & 7.7% knew about sign of
and effective interventions.2 neonatal illness.8 Newborn care practice
In Southern Asia, the proportion of neonatal such as taboo and superstation associated
deaths is highest (62 per cent) despite a with caring for the mother, which is
relatively high under-five mortality rate. adversely affect the newborn and child
India contributes the highest global share of health. Adequate awareness on newborn
deaths among the neonatal death in the care will improve household practice on
world. 1 In India neonatal mortality was 21.7 newborn care and use of the health service
per thousand live births in 2019. 5,6 often at community level. Therefore
Neonatal mortality still remains a major researcher is interested to identify the
public health problem and the leading cause awareness of primi post-natal mother
of mortality in children below 5 years of age regarding care of newborn.
in Nepal. Nepal faces a lot of health
challenges, as majority of people are MATERIALS AND METHODOLOGY:
uneducated, poor or less health conscious, A descriptive cross sectional study was
as a result health status indicator of Nepal conducted among 76 post-natal mothers
lag far behind these of developed countries. using purposive sampling technique. Ethical
One of the main reasons of this is due to the approval was taken from the research
low maternal awareness regarding care of committee of Patan Academy of Health
newborn.4 Newborn survival has become an Science, School of Nursing and Midwifery,
important issue to improve the child health Lalitpur Nursing Campus. Before taking
status and for achieving sustainable interview Informed verbal consent were
development goal. Neonatal health status taken from the each respondents and the
enhances by providing appropriate basic purpose of the study was explained. The
newborn care.8 collected data were analyzed by using SPSS
version 20. Descriptive statistics and
RATIONALE OF THE STUDY inferential statistics manly Chi-square test
Globally 99% of the newborn death was were used. There was total 7 components on
happening in low and middle-income awareness related to newborn care
countries where poor resources setting.9 questionnaire and total score 43 was
About half of the deaths occur at home considered 100%. Awareness level was
while they cared by mother, relatives and categorized by mean score; score above the
traditional birth attendance. mean considered good awareness and below
According to the Nepal’s Demographic the mean considered as poor awareness.
Health Survey 2016, 1 in 48 babies die in
their first 28 days of life, around 17% of RESULT
neonatal deaths have occurred within the Among the 76 post-natal mothers, majority
first hour of life. Overall, more than half of of respondents (93.4%) were from age
neonatal deaths have occurred within the above 20 years, the mean age was 26.36
first day of life (57%) where more than half years and minimum age is 16 years. Most of

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Sangita Panthi et.al. Awareness regarding care of newborn among post natal mothers in Teaching Hospital
Lalitpur

respondents (93.4%) had got secondary and joint family. Most of respondents (98.70%)
higher education. Similarly, more than half received Antenatal service more than four
of the respondents (57.90%) belonged to times during ANC period.

Table. 1 Respondent's response on Breastfeeding N=76

Variable No.(%)
Initiation of breastfeeding after birth
Within one hours b 65 (85.5%)
Two hours 9(11.8%)
Three hours 1(1.3%)
More than three hours 1(1.3%)
First feed
Breast milk b 75(98.7%)
Honey 1(1.3%)
Need of breastfeeding
On demand b 17(22.4%)
Every 2 hourly 59(77.6%)
Exclusive breastfeeding
Feeding only mother milk b 70(92.1%)
Feeding Brest milk with water 3(3.9%)
Feeding with cow milk and other milk Supplement 3(3.9%)
Duration of exclusive breastfeeding
3 months 1(1.3%)
5 months 1(1.3%)
6 months b 74(97.4%)
Note: a for multiple response question, b correct answer

Table.1 shows that most of respondents should breastfeed on demand. On awareness

(85.50%) gave the right answer regarding regarding meaning of exclusive
initiating breastfeeding after birth, likewise breastfeeding most of the respondents
all most all of the respondents (98.90%) (92.1%) answered that feeding only
answered that breastfeeding is first feeding mother’s milk, similarly on the duration of
to newborn, only one respondent answered exclusive breastfeeding 97.4 % of
honey is the first food to the newborn. respondents answered correctly that 6
Regarding need of breastfeeding only 22.4% months period is the exact duration of
of the respondents responded that newborn exclusive breastfeeding.

Table 2. Respondents’ Response on Cord care, Eye care and immunization N=76
Variables No. (%)
Material used in cord care
Cleaning with warm water and cottonb 61 (80.3%)
Soap and water 1(1.3%)
Oil 14(18.4%)
Material used in eye care
Cleaning eye with clean swabb 50 (65.8%)
Applying kajal (eyeliner) 10 (13.2%)
Milk 13(17.1%)
Oil 3(3.9%)
Appropriate time of first vaccination
Soon after birth b 56(73.7%)
After one month 6 (7.9%)
After 42 days 6(7.9%)
Don’t know 8(10.5%)
Note: b correct answer

Table 2 illustrates that most of the answered that cleaning eye by clean swab
respondent’s (80.3%) gave the right answer separately while 17.1% of the respondents
regarding material used in cord care that is gave wrong answer that breast milk is used
cleaning with warm water and cotton. for eye care similarly 13.2% answered
Regarding material used in eye care, about applying kajal in eye. All of the respondents
two third of the respondents (66%) correctly were aware that vaccine prevents disease

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Vol.12; Issue: 11; November 2022
Sangita Panthi et.al. Awareness regarding care of newborn among post natal mothers in Teaching Hospital
Lalitpur

while 73.7% of the respondents know about given soon after birth.
first vaccine Bacille Calmatte Guerin is

Table 3. Respondent’s response on Newborn danger sign N=76

Variables No. (%)
Danger signsa
Yellowness of eye palm sole 69(90.7%)
Red, pus discharging umbilicus and surrounding skin red 72 (94.7%)
Eye swollenness, sticky, red or draining pus 71(93.4%)
Baby stop or unable to breastfeeding 65(85.5%)
Abnormal jerking movement of limbs and eye 57(75.0%)
Difficulty and fast breathing 61 (80.2%)
Blister on skin 70 (92.1%)
Fever 64(84.1%)
Baby cold to touch 67(88.1%)
Baby previously active and become lethargic 61(80.2%)
Abdominal distention 60(78.9%)
Note: a Multiple response question

Table3. Regarding the awareness on danger

signs of newborn, most common danger Table 4. Shows that more than half of
sign identified by respondents was red pus respondents 40 (52.6%) had good level of
discharging umbilicus and surrounding skin awareness regarding care of newborn and
red (94.7%), followed by swollen eye, 36(47.4%) respondents had poor awareness.
sticky red or pus discharging eyes (93.4%), As seen from table 5 there was significant
blister on skin( 92.1%), baby cold to touch association between type of family and
(88.1%), newborn become lethargic, mother with awareness regarding care of
(80.1%) abnormal jerking movement newborn (p= 0.036) and no significant
(75%) respectively. association between age, education,
occupation and completed ANC with
Table 4. Respondents’ Overall Level of Awareness Regarding awareness regarding care of newborn where
Care of Newborn N=76
level of awareness No. (%) p value 0.663, 0.184, 0.454 and 0.221
Good awareness (>75 %) 40(52.6%) respectively.
Poor awareness (51%-75%) 36(47.4%)

Table 5. Association between Age, Education, Occupation, Type of family and ANC visit with Awareness regarding Newborn care
N=76

Variables Awareness on newborn care X2/ Fisher’s

Poor N (%) Good N (%) exact test P Value
Age
Below twenty years 3(3.9%) 2(2.6%) 0.343 0.663
Above twenty years 33(43.42%) 38(50%)
Education
Primary level 4(5.3%) 1(1.3%) 2.268 0.184
An above primary level 32(42.1%) 39(51.3%)
Occupation
Service
Yes 9(11.8%) 14(18.4%) 0.898 0.454
No 27(35.5%) 26(34.2%)
Type of family
Single 20(26.3%) 12(15.8%) 4.962 0.036*
Joint family 16(21.2%) 28(36.8%)
Complete antenatal visit
Yes 34(44.7%) 40(52.6%) 2.282 0.221
No 2(2.6%) 0 (0%)

Chi square test: p value (<0.05) level of significant.

Fisher Exact Test where p value less than 0.05 (2 tailed) is significance

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DISCUSSION A contradictory finding was observed in a

This study showed that more than half of the study conducted in Ghana where more than
mother had good awareness regarding 90 % of postnatal mothers had good
newborn care. The acquisition of knowledge knowledge regarding demand
of newborn care among primi para mother is breastfeeding.14 This study result is
commonly viewed as a key strategy to contradict with our present study due to
improve maternal and child health. ` difference in population where most of
This study revealed that 52.6% of respondents were multiparous while all
respondents had good awareness regarding respondents were primi para mother in our
care of newborn, 47.4% had poor study.
awareness. This is supported by previous The awareness regarding immunization in
study done in Pokhara Nepal on knowledge our study was satisfactory as about cent
and practice regarding newborn care where percent respondents were aware about
among 150 post-natal mothers 60.7% immunizing the child to prevent different
mother had good knowledge and 39.3% had communicable disease. Similarly, 73.7% of
poor knowledge.3 Similarly study conducted the respondents know about first vaccine
in Rwanda among 192 post-natal mothers Bacille Calmatte Guerin was given soon
showed that 65.1% had good knowledge after birth. This result supported by study
and 34.9% had poor knowledge regarding done in Sudan where 91.7% of mothers
essential newborn care.10 aware on need of vaccine and 81% of
The finding of the present study is mothers knew that vaccine prevents
contradicted with the study done in Chitwan disease.15
Nepal where 38.7% of respondents had Regarding danger signs of newborn in
good knowledge, 41.3% had average present study, most common danger sign
knowledge and 20% had poor knowledge identified by respondents were red pus
regarding newborn care.11 Another study discharging umbilicus and surrounding red
conducted in Dolpa Nepal among 302 skin (94.7%), followed by on swollen eye
mothers, identified that more than half of sticky red or pus discharging eyes (93.4%),
mothers (51.3%) demonstrated poor blister on skin (92.1%), baby cold to touch
knowledge regarding newborn care.12 The (88.1%), lethargic newborn (80.1%) and
differences in the findings is due to the abnormal jerking movement (75%). Similar
differences in study setting as the study conducted in Palpa Nepal revealed
respondents in this study were from the that, cent percent of respondents aware
capital city of Nepal with high literacy and about unable to suck as neonatal danger
well availability of the health service signs followed by fever (99.1%), breathing
This study shows that 100% of respondents difficulties and jaundice (88.2%), umbilical
responded that newborn should feed cord infection (83.6%), hypothermia
colostrum. However a study conducted in (62.7%) and least number of respondents
Ethiopia revealed that 18.7% of mother (18.2%) were aware about convulsion as a
incorrectly answered that cow’s milk, neonatal danger signs16. This result is
formula feeding (48%), plain water (12.3%) similar to our study because the age group
and sugar water (8.3 %) should be given and educational level of respondents were
before starting breast feeding13. Present also similar
study findings are contradicted with this
study due to their differences in level of CONCLUSIONS
education where most of respondents were On the basis of the findings, it can be
from primary level of education and have concluded that more than half of
different cultural practice. respondents had good awareness on
This study revealed that only 22.4% of newborn care, and nearly half of
respondents were aware on demand feeding, respondents had poor awareness regarding

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Sangita Panthi et.al. Awareness regarding care of newborn among post natal mothers in Teaching Hospital
Lalitpur

newborn care. Similarly, most of the DOI: https://doi.org/10.3126/ijssm.v8i1.335

respondents were aware on all of the 70
newborn danger signs. Based on the study 4. Shrestha T, Bhattarai SG, Silwal K.
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Every Child ALIVE , [internet] Available
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at: Newborn and child health | UNICEF
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Declaration by Authors care center in Nepal. Sri Lanka Journal of
Ethical Approval: Approved Child Health. 2016 Sep 5; 45(3). Available
Acknowledgement: None at:https://www.researchgate.net/publication/
307870022_Knowledge_attitude_and_practi
Source of Funding: None ces_on_the_care_of_the_newborn_in_postn
Conflict of Interest: The authors declare no atal_mothers_delivering_at_a_tertiary_care
conflict of interest. _centre_in_Nepal
9. Singh DR, Harvey CM, Bohara P, Nath D,
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