Objective To determine home based newborn care
practices in rural Nepal in order to inform strategies
to improve neonatal outcome.
Design Cross sectional, retrospective study using
structured interviews.
Setting Makwanpur district, Nepal.
Participants 5411 married women aged 15 to 49
years who had given birth to a live baby in the past
year.
Main outcome measures Attendance at delivery,
hygiene, thermal care, and early feeding practices.
Results 4893 (90%) women gave birth at home.
Attendance at delivery by skilled government health
workers was low (334, 6%), as was attendance by
traditional birth attendants (267, 5%). Only 461 (8%)
women had used a clean home delivery kit, and about
half of attendants had washed their hands. Only 3482
(64%) newborn infants had been wrapped within half
an hour of birth, and 4992 (92%) had been bathed
within the first hour. 99% (5362) of babies were breast
fed, 91% (4939) within six hours of birth. Practices
with respect to colostrum and prelacteals were not a
cause for anxiety.
Conclusions Health promotion interventions most
likely to improve newborn health in this setting
include increasing attendance at delivery by skilled
service providers, improving information for families
about basic perinatal care, promotion of clean
delivery practices, early cord cutting and wrapping of
the baby, and avoidance of early bathing.