Newborn Care Practices in An Urban Slum of Dhaka: Comparison of Use of Care At BRAC Delivery Centers and At Homes – A Cross Sectional Study

Background: Neonatal mortality in urban slums of Dhaka is twice than in urban non-slums areas. BRAC, Bangladeshi NGO, initiated a community based Manoshi program and established delivery centers in urban slums to improve maternal, newborn, and child health. This study was undertaken to compare newborn care practices related to cord care, thermal care, bathing and initiation of breastfeeding in delivery centers and at homes, in an urban slum of Dhaka. Methods: A cross-sectional study included 130 mothers; 99 who delivered at centers and 31 at homes from January to November 2010. Six in-depth interviews were also conducted from mothers to explore newborn care practices. Results: About 99% center-delivered and 93.5% home-delivered mothers received the ANC during their last pregnancy. All centered deliveries were conducted by the BRAC trained urban birth attendants whereas all home deliveries were conducted by traditional birth attendants. In center deliveries, 96% used new blade and all used new thread to cut the cord. Of those, 70% boiled thread and 28% boiled blade. In home deliveries, all used new blade and thread to cut and tie the umbilical cord. Of those, 84% boiled blade and 39% boiled thread. Overall, 91% newborns were dried and 96% wrapped immediately after birth in new/clean clothes. Of those, 76% were dried before and 70% wrapped after the delivery of placenta. In center-deliveries, 96% newborns were placed on mother’s abdomen and 92% given bath on/or after third day. About 98% mothers initiated breastfeeding within 24-hours and all gave colostrum to their babies. In home-deliveries, 26% newborns were placed onto surface and 62% not given bath on/or after third day. About 23% mothers discarded colostrum. Conclusion: Newborn care practices were comparatively better in center deliveries but still remain a great cause of concern among home deliveries that may hamper the health of newborns.