Participants’ socio-demographic characteristics
Totally 147midwives were participated in the study which gives a response rate of 98%. Among the respondents 88 (59.9%) were from health centerand 59(40.1%) fromhospitals.One hundred seventeen (79.6%) were females and 35(23.8%) of the participants were in the age group of 25-29. Orthodox Christianity was thedominant religion consisting of 135(91.8%).Majority (83.0%) of the respondents were diploma, 55 (37.4%) respondents had work experience of 1-5 years and 49.7% were married.
Participants Knowledge on immediate newborn care
Participants responded that theadvantage of early initiation of breastfeeding; 97(66%) said,it prevents the newborn from hypoglycemia and 91 (61.9%) of respondents know the advantage of colostrumon preventing new-born baby from infection.Among all, 137(93.2%) of respondents had knowledge on the appropriate time of initiation of breastfeeding for the newborn baby.
Most of the respondents know on placing the newborn on mother’s abdomen 122(83%) immediately after delivery and 127(86.4%) of midwives had knowledge of providing TTC eye ointment on both eyes.(Table S1).When the respondents asked about the immediate new-born complications, majority of them identified hypothermia, hypoxia and infection (Table S2).Around 9(6.15) of mothers wash babies before 24 hours of delivery(Table 1)
Table-1: Knowledge of midwives on care given to immediately born baby in central zone, Tigray, Ethiopia, 2016
Variable
|
Frequency (N=147)
|
Percent
|
Knowledge of midwives on advantage of skin-to-skin contact
|
Prevent hypothermia
|
64
|
55.8%
|
Help baby stay warm
|
84
|
57.1%
|
Bonding
|
40
|
27.2%
|
Help expel placenta and uterine contraction
|
2
|
1.4%
|
Knowledge of midwives on measures to be taken for baby unable to cry after delivery
|
Suck the baby
|
136
|
92.5%
|
Call a help and start resuscitation
|
105
|
71.4%
|
Start cardio-pulmonary resuscitation
|
10
|
6.8%
|
Burbing
|
3
|
2.0%
|
Oxygen administration
|
4
|
2.7%
|
Knowledge on time of bathing for immediately born baby
|
Before 24 hour of delivery
|
9
|
6.1%
|
After 24 hour of delivery
|
110
|
74.8%
|
I do not know
|
5
|
3.4%
|
Counsels mother to wash at home after 24 hour
|
23
|
15.6%
|
Knowledge on the importance of providing eye ointment
|
Prevent eye infection
|
57
|
38.8%
|
Prevent blindness
|
12
|
8.2%
|
Prevent conjunctivitis
|
21
|
14.3%
|
Prevent from STI
|
23
|
15.7%
|
Prevent Gonorrhoea
|
2
|
1.4%
|
Prevent syphilis
|
8
|
5.5%
|
As prophylaxis
|
8
|
5.5%
|
Prevent dryness of eye
|
1
|
0.7%
|
The overall Knowledge of midwives on immediatenewborn care was 17.7%, 57.1% and 25.2%, good, fair and poor knowledge respectively.
Participants practice of newborn care
Around 146(99.3%) of respondents have prepared cord tie and clamp before delivery, but 98% of midwives did not prepared baby identification material (Table 2).
Table-2: Practice of midwives on immediate newborn care in central zone, Tigray, Ethiopia, 2016
Variable
|
Frequency N=147
|
Percent
|
Washes hands with soap and water, dried with a clean dry
|
Perform task completely
|
36
|
24.5%
|
Unable to perform task completely
|
111
|
75.5%
|
Wipes the eyes and face when the head is delivered
|
Perform task completely
|
94
|
63.9%
|
Unable to perform task completely
|
53
|
36.1%
|
Clean eyes immediately after birth with swab soaked in sterile water, using separate swab for each eye
|
Perform task completely
|
44
|
29.9%
|
Unable to perform task completely
|
103
|
70.1%
|
Delivery surface covered with sterile dry towel
|
Perform task completely
|
135
|
91.8%
|
Unable to perform task completely
|
12
|
8.2%
|
When baby not cried within 30 minute of delivery, called help and prepared for steps of resuscitation
|
Perform task completely
|
42
|
85.7%
|
Unable to perform task completely
|
7
|
14.3%
|
Use appropriate size of mask for resuscitation
|
Perform task completely
|
45
|
91.8%
|
Unable to perform task completely
|
4
|
8.2%
|
Cord Tie
|
Perform task completely
|
84
|
57.1%
|
Unable to perform task completely
|
63
|
42.9%
|
Cord cut with sterile scissor or surgical blade.
|
Perform task completely
|
99
|
67.3%
|
Unable to perform task completely
|
48
|
32.7%
|
About 146(99.3%) of participants in this study were not practiced to put baby identification bands on the wrist and ankle after delivery.Majority of the respondents, 145(98.6%) have immediately dried the whole body of baby including the head and limbs but 14(9.5%) of respondents have not removed wet cloth used to dry the baby. Most 145(98.6%) of respondents were administered vitamin K to the new-born immediately.
Overall 52.4%of midwives practiced immediate newborn care appropriately.
Factors associated with immediate newborn care
Variables which have p-value less than or equal to 0.3 in Bivariate analysis were entered to multi-variable analysis. The multi-variable analysis result showed that work environment was significantly associated with practice of new-born care that is midwives working at health center were 82% lower odds of new-born care compared to those working in the hospitals (Table 3)
Table-3: Multivariable analysis of variables with practice of newborn care, among Midwives working in central zone, Tigray, Ethiopia, 2016.
Variables
|
Practiced New-born Care
|
COR ( 95% CI)
|
AOR( 95% CI)
|
P-Value
|
Yes, n (%)
|
No, n (%)
|
Marital status
|
Single
|
23(48.9%)
|
24(51.1%)
|
1
|
1
|
|
Married
|
48(65.8%)
|
25(34.2%)
|
2.00(0.94, 4.23)
|
1.90(0.79, 4.58)
|
0.15
|
Divorced
|
2(16.7%)
|
10(83.3%)
|
0.20(0.04, 1.05)
|
0.22(0.04, 1.26)
|
0.09
|
Widowed
|
4(26.7%)
|
11(73.3%)
|
0.38(0.10, 1.36)
|
0.40(0.09, 1.73)
|
0.22
|
Religion
|
Orthodox
|
74(54.8%)
|
61(45.2%)
|
1
|
1
|
0.036
|
Muslim
|
3(25.0%)
|
9(75.0%)
|
0.27(0.07, 1.06)
|
0.19(0.04, 0.89)
|
Working environment
|
Hospital
|
46(78.0%)
|
13(22.0%)
|
1
|
1
|
0.000
|
Health Center
|
31(35.2%)
|
57(64.8%)
|
0.15(0.07, 0.32)
|
0.18(0.07, 0.43)
|
Educational status
|
Diploma
|
60(49.2%)
|
62(50.8%)
|
1
|
1
|
0.87
|
Degree
|
17(68.0%)
|
8(32.0%)
|
2.2(0.88, 5.47)
|
1.10(0.32, 3.72)
|
Knowledge on Newborn care
|
Fair
|
43(51.2%)
|
41(48.8%)
|
1
|
1
|
|
Good
|
16(61.5%)
|
10(38.5%)
|
1.52(0.62, 3.75)
|
1.42(0.48, 4.17)
|
0.52
|
Poor
|
18(48.6%)
|
19(51.4%)
|
0.90(0.42, 1.96)
|
1.3(0.51, 3.33)
|
0.57
|
Training on newborn care
|
Yes
|
15(71.4%)
|
6(28.6%)
|
1
|
1
|
0.25
|
No
|
62(49.2%)
|
64(50.8%)
|
0.38(0.14, 1.06)
|
0.48(0.14, 1.65)
|