Understanding Community Beliefs and Practices During the Postnatal Period to Better Design Newborn Heath Interventions

Background: Understanding local knowledge and practices during the newborn period is needed in the development of effective interventions to reduce neonatal mortality.

 

Methods: A qualitative study was conducted to describe beliefs and perceptions of community members, volunteers and health extension workers on the acceptability of home visits during pregnancy and post natal period.  Three rural communities  in Sidama zone of the Southern Nations, Nationalities and Peoples’ Region (SNNPR) of Ethiopia were studied.  

Twenty-one individual interviews and six focus group discussions with recent mothers, fathers and paternal grandmothers, Health Extension Workers (HEW) and Volunteer Community Health Workers (VCHWs) were conducted in three community sites in Sidama Zone of SNNPR.

Results: Findings demonstrate that community members appreciate the benefit of home visits by HEWs and VCHWs. The worker’s gender, training in maternal and newborn health, and level of education directly impacted the perceived benefits and acceptance of home visits.

The majority of participants interviewed saw gender as a crucial factor in determining access for VCHWs. During pregnancy, women are often not speaking with men about their pregnancy. After delivery, men may not be allowed inside the home. Either grandmother or father decides who has access to the baby.

HEWs mentioned their inability to treat newborns as a prime barrier to access. The mothers, fathers and grandmothers interviewed all accepted the need for home visits by HEWs and VCHWs, particularly after birth.

Conclusions: Attention to local beliefs is critical to design interventions to reach mothers and newborns in the immediate post-partum visits. Qualitative research can increase the effectiveness of interventions. Female health worker gender, higher educational level and perceived skills in maternal and newborn health all improve the chances that a health worker can gain access to mothers and newborns in their homes and that their counselling will be followed