Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study

Abstract Background WHO recommends essential newborn care practices that every newborn needs for health and survival regardless of birthplace. Previous Ethiopian studies of these actions had long recall periods and most considered either facility or home deliveries. We aimed to assess selected pract...

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Main Authors: Tadesse Guadu, Kassahun Alemu, Joanna Schellenberg, Della Berhanu, Seblewengel Lemma, Atkure Defar, Theodros Getachew, Girum Taye, Solomon Shiferaw, Zewditu Abdissa, Amare Tariku, Meseret Zelalem, Lars Åke Persson
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07959-5
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author Tadesse Guadu
Kassahun Alemu
Joanna Schellenberg
Della Berhanu
Seblewengel Lemma
Atkure Defar
Theodros Getachew
Girum Taye
Solomon Shiferaw
Zewditu Abdissa
Amare Tariku
Meseret Zelalem
Lars Åke Persson
author_facet Tadesse Guadu
Kassahun Alemu
Joanna Schellenberg
Della Berhanu
Seblewengel Lemma
Atkure Defar
Theodros Getachew
Girum Taye
Solomon Shiferaw
Zewditu Abdissa
Amare Tariku
Meseret Zelalem
Lars Åke Persson
author_sort Tadesse Guadu
collection DOAJ
description Abstract Background WHO recommends essential newborn care practices that every newborn needs for health and survival regardless of birthplace. Previous Ethiopian studies of these actions had long recall periods and most considered either facility or home deliveries. We aimed to assess selected practices, i.e., thermal care, cord care, initiation of breastfeeding, and first immunizations among neonates born at health facilities and homes in Ethiopia. Methods We used data from the Performance Monitoring for Action Ethiopia 2019–2020 survey and analyzed 2,493 live births whose mothers completed interviews at seven weeks postpartum in five regions, namely Tigray, Afar, Amhara, Oromia, Southern Nations, Nationalities and Peoples regions, and Addis Ababa. Practices were assessed using an interviewer-administered questionnaire. Essential newborn care indicators were analyzed among neonates born at health facilities and homes and expressed as proportions with a 95% confidence interval. Clustering was accounted for in all analyses. Results Practices were assessed among 1532 (61%) facility-born and 961 (39%) home-born neonates. Some of the appropriate actions had higher coverage at health facilities: skin-to-skin care 76% vs. 9%, immediate drying and wrapping with a cloth 80% vs. 79%, delayed bathing until 24 h after birth 73% vs. 39%, appropriate instrument to cut the cord 100% vs. 94%, use of new or boiled instrument 90% vs. 79%, nothing or chlorhexidine applied on cord 89% vs. 64%, first-hour initiation of breastfeeding 69% vs. 62%, and BCG and first polio immunization within the first six weeks after birth 54% vs. 20%. Thermal care, cord care, and provision of vaccines at birth were relatively more common in Addis Ababa, while first-hour breastfeeding initiation was higher in the Oromia region. Conclusion Neonates born at health facilities had higher, although not optimal, coverage of thermal care, cord care, early breastfeeding initiation, and the first immunizations. Strengthening the health extension program to promote facility delivery, further enhancing the coverage and quality of essential newborn care at health facilities, and increasing the coverage of first vaccinations and other essential services after birth are crucial for improving neonatal health and survival in Ethiopia.
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spelling doaj-art-c0b9d1932da048119a76ebc3e785477a2025-08-20T03:06:41ZengBMCBMC Pregnancy and Childbirth1471-23932025-08-012511910.1186/s12884-025-07959-5Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional studyTadesse Guadu0Kassahun Alemu1Joanna Schellenberg2Della Berhanu3Seblewengel Lemma4Atkure Defar5Theodros Getachew6Girum Taye7Solomon Shiferaw8Zewditu Abdissa9Amare Tariku10Meseret Zelalem11Lars Åke Persson12Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Epidemiology & Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of GondarDepartment of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineDepartment of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineDepartment of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineDepartment of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteHealth System and Reproductive Health Research Directorate, Ethiopian Public Health InstituteSchool of Public Health, Addis Ababa UniversityInstitute of Public Health, College of Medicine and Health Sciences, University of GondarInstitute of Public Health, College of Medicine and Health Sciences, University of GondarMaternal, Child and Adolescent Health Lead Excutive Office, Ministry of HealthDepartment of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical MedicineAbstract Background WHO recommends essential newborn care practices that every newborn needs for health and survival regardless of birthplace. Previous Ethiopian studies of these actions had long recall periods and most considered either facility or home deliveries. We aimed to assess selected practices, i.e., thermal care, cord care, initiation of breastfeeding, and first immunizations among neonates born at health facilities and homes in Ethiopia. Methods We used data from the Performance Monitoring for Action Ethiopia 2019–2020 survey and analyzed 2,493 live births whose mothers completed interviews at seven weeks postpartum in five regions, namely Tigray, Afar, Amhara, Oromia, Southern Nations, Nationalities and Peoples regions, and Addis Ababa. Practices were assessed using an interviewer-administered questionnaire. Essential newborn care indicators were analyzed among neonates born at health facilities and homes and expressed as proportions with a 95% confidence interval. Clustering was accounted for in all analyses. Results Practices were assessed among 1532 (61%) facility-born and 961 (39%) home-born neonates. Some of the appropriate actions had higher coverage at health facilities: skin-to-skin care 76% vs. 9%, immediate drying and wrapping with a cloth 80% vs. 79%, delayed bathing until 24 h after birth 73% vs. 39%, appropriate instrument to cut the cord 100% vs. 94%, use of new or boiled instrument 90% vs. 79%, nothing or chlorhexidine applied on cord 89% vs. 64%, first-hour initiation of breastfeeding 69% vs. 62%, and BCG and first polio immunization within the first six weeks after birth 54% vs. 20%. Thermal care, cord care, and provision of vaccines at birth were relatively more common in Addis Ababa, while first-hour breastfeeding initiation was higher in the Oromia region. Conclusion Neonates born at health facilities had higher, although not optimal, coverage of thermal care, cord care, early breastfeeding initiation, and the first immunizations. Strengthening the health extension program to promote facility delivery, further enhancing the coverage and quality of essential newborn care at health facilities, and increasing the coverage of first vaccinations and other essential services after birth are crucial for improving neonatal health and survival in Ethiopia.https://doi.org/10.1186/s12884-025-07959-5Essential newborn careFacility careHome careEthiopia
spellingShingle Tadesse Guadu
Kassahun Alemu
Joanna Schellenberg
Della Berhanu
Seblewengel Lemma
Atkure Defar
Theodros Getachew
Girum Taye
Solomon Shiferaw
Zewditu Abdissa
Amare Tariku
Meseret Zelalem
Lars Åke Persson
Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study
BMC Pregnancy and Childbirth
Essential newborn care
Facility care
Home care
Ethiopia
title Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study
title_full Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study
title_fullStr Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study
title_full_unstemmed Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study
title_short Essential newborn care practices at health facilities and homes in Ethiopia: a cross-sectional study
title_sort essential newborn care practices at health facilities and homes in ethiopia a cross sectional study
topic Essential newborn care
Facility care
Home care
Ethiopia
url https://doi.org/10.1186/s12884-025-07959-5
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