CHAPTER ONE

INTRODUCTION

1.1 Introduction/ Background

Neonate is a newborn baby, specifically a baby in the first four weeks after birth. After a month, a baby is no longer consider a neonate (William C et al., 2021). New born care is of immense importance for the survival and proper development and health life of a baby (Shajahan et al, 2012). It is strongly influence by home care practices instituted by the mother as well as new born care services at health facilities. The three major causes of neonatal deaths worldwide are infections (36% which include sepsis, pneumonia, tetanus and diarrhea). Pre-term (28%) and birth asphysix (23%) (Wang et al, 2014).

Newborn care in very important in preventing neonatal deaths, particularly essential care of the normal newborn to prevent illness which include extra care of low birth weight babies and access to quality emergency care for the sick newborn (Darmstadt et al, 2005). The health of newborn depends on the care provided by the caregivers. The care given to the newborn immediately after birth and both early and late neonatal period is critical in determining its survival. Simple cost-effective interventions such as hygienic cord care and early exclusive breastfeeding helps in prevention of infection and promote child growth respectively (Cousen, 2005).

However, the care needed by newborns may not be appropriately available to them by their caregivers due to various factors including socio-cultural, economic and demographic factors affecting mothers as well as other caregivers for instance, some cultural practices hinder the health and survival of the newborn (Lartey, 2009). Young first-time mothers are often likely to follow this blindly.

Improvement of newborn care has been central concern at international level. These include Millennium Development Goal, Global Strategy for Women and child health and health for all policy among others. Current global evaluations confirmed that commitment to improving newborn health makes meaningful socio-economic contributions (Yinger et al, 2003). Newborn health is closely related to that of their mothers.

In addition, newborn have a unique need that must be addressed in the context of maternal and child health services (Tinkers, 2003). Tinka et al (2003) further argued that millions of newborn deaths could be avoided if more resources were invested in proven low-cost interventions designed to address newborn needs although newborn care is a very essential element in reducing child mortality, it often receives less than optimum attention (Marah, 2011). Each year close to 7.7 million children under five years die around the world: out of which approximately 3.1 million of the newborns die during the neonatal period and almost all these (99%) deaths occur in the developing countries (WHO, 2020).

According to the World Health Organization estimation, neonatal deaths account for 45% of the under five deaths. More than one-third of these deaths take place in the first 24hour of birth, whereas three-quarter of the neonatal deaths take place in the first seven days of birth (Shahrzad Nematollahi et al, 2019).

Among the 17 sustainable development Goals (SDGs) set by United Nations in 2015, the 3^rd goal, target (No. 32) state that all countries aim to put a stop to millions of available deaths of newborns and under-five children by 2030. The targets to achieve are: reduction in neonatal mortality and under-5 mortality to no more than 12 and 35 deaths per 1000 live births respectively. Majority of low income countries are far behind achieving this goal mainly because of slow progress in reducing neonatal death (Javed Menon et al, 2019).

Parents often dream of what their new baby may look like. They think about a pink, round chubby cheeked and gurgling wonder. It may be surprising for many parents to see their newborn first time-wet and red, with a long head/ and screaming nothing at all like they had imagined. Newborns have many variations in normal appearance, from color differences to the shape of the head. Some of these differences are just temporary, part of the physical adjustment. Understanding the normal appearance of newborns can help you know that your baby is healthy. Some of the normal variations in newborns include the following:

Color: A baby’s skin color can vary greatly depending on the baby’s age, race or ethnic group, temperature, and whether or not the baby is crying. When a baby is first born, the skin is a dark red or purple color. As the baby starts to breathe air, the color changes to red. The redness normally starts to fade in the first day. A baby’s hand and feet may stay bluish in color for several days but blue coloring of other parts of the body isn’t normal. Some newborns develop a yellow coloring of the skin and whites of the eyes called Jaundice. This may be a normal response as the body gets rid of older blood cells. But it may indicate a problem, especially if it worsens.

Molding: Is the regular shape of the baby’s head from the birth process. Normal shape usually returns by the end of the first week.

Swollen Genitals/ discharge: Premature baby girls may have a very prominent clitoris and inner labia. Girls may have small amount of whitish discharge or blood tinged mucus from the vagina. This is a normal occurrence related to the mothers’ hormones. Premature boys may have a smooth, flat scrotum with undescended testicle. Boys born later in pregnancy have ridges in the scrotum with descended testicles (Stanford Children, 2021).

Lanugo: This is soft, downy hair on the baby’s body especially on the shoulders, noticeable in premature babies. It will slowly disappear.

1.2 Statement of Problem

Globally 7.7 million newborns die every year before they reach the age of one year. Out of which approximately 3.1 million are neonate’s death during the neonatal period and almost all these (99%) deaths occur in the developing countries. More than one third of these deaths occur in the first 24hour of birth whereas three quarter of the neonatal deaths takes place in the first seven days of birth (Biomed Central, 2019).

In Sub-Saharan Africa, Mothers use types of Substance commonly applied to the cord varied between countries: shea butter in Ghana and Mozambique, butter in Ethiopia, Cooking oil or herbs in Tanzania and Powder, salt water or herbs in Uganda. There was a desire for the cord to drop off quickly in several countries and this was one of the main reasons for applying substances in Uganda, Ghana, Ethiopia, Nigeria, and Malawi (Margaret bee et al, 2018).

In Cameroon, it’s estimated by WHO (2020) that close to 50,000 deaths are of neonatal origin due to inadequate knowledge of mothers, towards neonatal care within the first few days of life and onwards.

The investigator on a visit to a village in the Southwest (Muyuka) witnessed a postnatal mother apply herbs to a baby’s cord, some traditional balms on the baby’s eyes, which she said were “antibacterial agent”.

Another experience was observed in her neighborhood, where another postnatal woman a mother who said the baby had not passed out the normal black stool as supposed by every baby, within 7days, so she harvested some herbs crushed them on a dirty grinding stone and without washing hands, took this mixture to pump the baby with (do a rectal enema) with all these introduction of non-specific herbs, it will lead to the introduction of more micro-organisms into baby’s system, which can cause retarded growth, severe infection and most often death, leaving the investigator with the worry of investigating the knowledge on neonatal care amongst mothers.

1.3 Research Question

What is the knowledge of mothers on the care given to neonates?

1.4 Research Objectives

1.4.1 General Objectives

The aim of this study is to investigate mother’s knowledge on the care rendered to neonates.

To investigate their knowledge on the complications of poor neonatal care.