Delivery practices, hygiene, birth attendance and neonatal infections in Karamoja,  Uganda: a community-based study.

Leah J Hopp
127 Wakefield Crescent, London, Ontario, N5X 1Z6, Canada

Abstract
Background: Drawing attention to home birth conditions and subsequent neonatal infections is a key starting point to reducing neonatal morbidity which are a main cause of mortality in sub-Saharan Africa.

Objectives:To determine the proportion of respiratory, ophthalmic, and diarrhoeal infections in neonates; the proportion of mothers of neonates, following clean delivery practices; and to explore existing community practices during delivery and the neonatal period.

Methods: A descriptive, cross-sectional, exploratory study, including 10 questionnaires and five Key-Informant interviews, in rural Karamoja, Uganda.

Results:Post-delivery razor blade and string use was 90%, but clean delivery surface use only 30%, while 90% obtained bathing water for neonates from boreholes. No mothers washed hands after latrine-related activities compared with 83% for food-related activities. None delivered in health centres or with skilled birth attendants. Respiratory infections occurred in eight neonates, compared to two ophthalmic infections, and no diarrhoea.

Conclusion:Use of clean delivery surfaces needs to be improved as well as washing after latrine-related activities. Diarrhoea was far less common than expected. Since rural Mother-Infant pairs spend the majority of their post-delivery time around the homestead, hygiene impacts neonatal infections to a large degree, possibly even more so than delivery practices.

Keywords: Neonatal, birth, delivery, clean delivery kit (CDK), clean delivery practices, infection, diarrhoea, ophthalmic, respiratory, hygiene, traditional birth attendant (TBA), home, rural, community, Nakaale, Nakapiripirit, Karamoja, Uganda