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* J Health Popul Nutr >
* v.24(4); Dec 2006 >
* PMC3001155

J Health Popul Nutr. 2006 December; 24(4): 508–518.
PMCID: PMC3001155
Immediate and Early Postnatal Care for Mothers and Newborns in Rural Bangladesh Uzma Syed,1 Sk. Asiruddin,2 Md. S.I. Helal,2 Imteaz I. Mannan,2 and John Murray2 Author information ► Copyright and License information ► This article has been cited by other articles in PMC.

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Abstract
The study evaluated the impact of essential newborn-care interventions at the household level in the Saving Newborn Lives project areas. Two household surveys were conducted following the 30-cluster sampling method using a structured questionnaire in 2002 (baseline) and 2004 (endline) respectively. In total, 3,325 mothers with children aged less than one year in baseline and 3,110 mothers in endline from 10 sub-districts were interviewed during each survey. The proportion of newborns dried and wrapped immediately after birth increased from 14% in 2002 to 55% in 2004; 76.2% of the newborns were put to the mother's breast within one hour of birth compared to 38.6% in baseline. Newborn check-up within 24 hours of delivery increased from 14.4% in 2002 to 27.3% in 2004. Postnatal check-up of mothers by trained providers within three days of delivery rose from 2.4% in 2002 to 27.3% in 2004. Knowledge of the mothers on at least two postnatal danger signs increased by 17.2%, i.e. from 47.1% in 2002 to 64.3% in 2004. Knowledge of mothers on at least three postnatal danger signs also showed an increase of 16%. Essential newborn-care practices, such as drying and wrapping the baby immediately after birth, initiation of breastmilk within one hour of birth, and early postnatal newborn check-up, improved in the intervention areas. Increased community awareness helped improve maternal and newborn-care practices at the household level. Lessons learnt from implementation revealed that door-to-door visits by community health workers, using community registers as job-aids, were effective in identifying pregnant women and following them through pregnancy to the postnatal periods. Key words: Obstetric care, Postnatal care, Danger signs, Pregnancy, Community health workers, Impact studies, Bangladesh Go to:

INTRODUCTION
Despite improvement in the infant and child health status, a high number of neonatal deaths (41 per 1,000 livebirths) pose a serious public-health concern in developing countries, including Bangladesh. Globally, almost three-quarters of neonatal deaths occur within the first seven days of delivery (1). However, there is a significant break in the continuum of care in the service-delivery strategy. The burden of maternal complications and deaths is also highest in the first few days of delivery (2, 3). Thus, immediate and early postnatal interventions (defined to be from delivery to first seven days), have the potential to change the maternal and child mortality scenario significantly in Bangladesh. In Bangladesh, the perinatal (stillbirths and early neonatal) and late neonatal mortality scenario reflects a dreadful picture. To address the problem, governmental and non-governmental organizations (NGOs) have been implementing various interventions. The Saving Newborn Lives (SNL), an international initiative funded by the Bill and Melinda Gates Foundation, was launched in 2000 to improve the health of newborns globally. Its overall goal is to improve neonatal health and survival. The primary strategic objective to achieve this goal was to increase and sustain key health-practices and the use of...
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