Care-seeking practices for sick neonates: Findings from cross-sectional survey in 14 rural sub-districts of Bangladesh

PLoS One. 2018 Sep 27;13(9):e0204902. doi: 10.1371/journal.pone.0204902. eCollection 2018.

Abstract

Objectives: Neonatal deaths account for 45% of all under-five deaths globally and 60% in Bangladesh. This study aimed to investigate the most common symptoms and complications in neonates, care-seeking practices of the mothers for their sick neonates, and factors associated with the care-seeking practices.

Methods: This cross-sectional study analysed data from an Endline Household Survey (as part of an evaluation of a paired cluster-randomised controlled trial study in 14 rural sub-districts in Bangladesh) of 2,931 women who gave birth recently. Descriptive analysis and logistic regressions were conducted to identify the care-seeking practices of mothers of sick neonates and the factors associated with the care-seeking from trained providers.

Results: Of the 2868 neonates, 886 (30.9%) were reported ill during first 28 days after birth. For those with reported symptoms, 748 (84.4%) of their mothers sought care. Of those who sought care, 65.2% sought care from untrained providers. Multiple logistic regression analysis showed significantly higher odds of care-seeking from trained providers when neonates had 3 or more concurrent symptoms (OR: 1.82; 95% CI: 1.07-3.08); when mothers perceived their neonates' symptoms as severe (OR: 4.08; 95% CI: 2.92-5.70); when mothers received skilled care during pregnancy (OR: 1.95; 95% CI: 1.34-2.84); and when mothers had their delivery in a facility (OR: 3.50; 95% CI: 2.18-5.62). Mothers who delivered their babies at a facility, 43.1% of them sought care for their sick neonates at the same type of public hospital and 34.9% from same type of private hospitals where their deliveries took place.

Conclusion: Skilled care for mothers during pregnancy and delivery, and mothers' perceptions of the severity of symptoms are the key associated factors of care-seeking for sick neonates from trained providers. Interventions should be tailored to increase care from trained providers during pregnancy and delivery at facilities to improve care-seeking for neonates from trained providers and for the survival of neonates.

Publication types

  • Clinical Trial
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Bangladesh / epidemiology
  • Delivery of Health Care*
  • Female
  • Humans
  • Infant
  • Infant Mortality*
  • Infant, Newborn
  • Infant, Newborn, Diseases / mortality*
  • Male
  • Maternal Health Services*
  • Pregnancy

Associated data

  • figshare/10.6084/m9.figshare.6948956

Grants and funding

This study was financially supported by Australian Agency for International Development through UNICEF (SEA). The grant number and URL are GR-00699 and www.unicef.org.bd. The funder had no role in study design, data collection and analysis or preparations of the manuscript.