Understanding home-based neonatal care practice in rural southern Tanzania

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 102; no. 7; pp. 669 - 678
• Main Authors: Mrisho, Mwifadhi, Schellenberg, Joanna Armstrong, Mushi, Adiel K., Obrist, Brigit, Mshinda, Hassan, Tanner, Marcel, Schellenberg, David
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-07-2008; Royal Society of Tropical Medicine and Hygiene; Elsevier
• Subjects: Biological and medical sciences; Breast Feeding - ethnology; Breast Feeding - psychology; Culture; Delivery. Postpartum. Lactation; Female; General aspects; Gynecology. Andrology. Obstetrics; Health Knowledge, Attitudes, Practice; Home Care Services - standards; Home childbirth; Home Childbirth - psychology; Home Childbirth - standards; Humans; Infant Care - psychology; Infant Care - standards; Infant Mortality - trends; Infant, Newborn; Maternal health services; Medical sciences; Medicine, Traditional; Mothers - psychology; Neonatal care practices; Newborn infants; Patient Acceptance of Health Care - ethnology; Patient Acceptance of Health Care - psychology; Perinatal Care - standards; Pregnancy; Qualitative Research; Rural health; Rural Health - standards; Socioeconomic Factors; Tanzania; Africa; Tanzania; Rural health; Maternal health services; Neonatal care practices; Newborn infants; Home childbirth; Tanzania; Human; Neonatal; Rural environment; South; Infant; Comprehension; Birth; Knowledge; Care; Pregnancy; Newborn; Mother; Professional practice; At home; Delivery; Public health
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2008.04.029

In order to understand home-based neonatal care practices in rural Tanzania, with the aim of providing a basis for the development of strategies for improving neonatal survival, we conducted a qualitative study in southern Tanzania. In-depth interviews, focus group discussions and case studies were used through a network of female community-based informants in eight villages of Lindi Rural and Tandahimba districts. Data collection took place between March 2005 and April 2007. The results show that although women and families do make efforts to prepare for childbirth, most home births are assisted by unskilled attendants, which contributes to a lack of immediate appropriate care for both mother and baby. The umbilical cord is thought to make the baby vulnerable to witchcraft and great care is taken to shield both mother and baby from bad spirits until the cord stump falls off. Some neonates are denied colostrum, which is perceived as dirty. Behaviour-change communication efforts are needed to improve early newborn care practices.