Current Neonatal Skin Care Practices in Four African Sites

Data for this study on skin care practices and emollient use in four African sites were collected using in-depth interviews, focus-group discussions and observations. Respondents were mothers, grandmothers, fathers, health workers, birth attendants and people selling skin-care products. Analysis included content and framework analyses.Emollient use was a normative practice in all sites, with frequent application from an early age in most sites. There were variations in the type of emollients used, but reasons for use were similar and included improving the skin, keeping the baby warm, softening/strengthening the joints/bones, shaping the baby, ensuring flexibility and encouraging growth and weight gain. Factors that influenced emollient choice varied and included social pressure, cost, availability and deep-rooted traditional norms. Massage associated with application was strong and potentially damaging to the skin in some sites.Given the widespread use of emollients, the repeated exposure of newborns in the first month of life and the potential impact of emollients on mortality, trials such as those that have been conducted in Asia are needed in a range of African settings

"Why not bathe the baby today?": A qualitative study of thermal care beliefs and practices in four African sites

BACKGROUND: Recommendations for care in the first week of a newborn's life include thermal care practices such as drying and wrapping, skin to skin contact, immediate breastfeeding and delayed bathing. This paper examines beliefs and practices related to neonatal thermal care in three African countries. METHODS: Data were collected in the same way in each site and included 16-20 narrative interviews with recent mothers, eight observations of neonatal bathing, and in-depth interviews with 12-16 mothers, 9-12 grandmothers, eight health workers and 0-12 birth attendants in each site. RESULTS: We found similarities across sites in relation to understanding the importance of warmth, a lack of opportunities for skin to skin care, beliefs about the importance of several baths per day and beliefs that the Vernix caseosa was related to poor maternal behaviours. There was variation between sites in beliefs and practices around wrapping and drying after delivery, and the timing of the first bath with recent behavior change in some sites. There was near universal early bathing of babies in both Nigerian sites. This was linked to a deep-rooted belief about body odour. When asked about keeping the baby warm, respondents across the sites rarely mentioned recommended thermal care practices, suggesting that these are not perceived as salient. CONCLUSION: More effort is needed to promote appropriate thermal care practices both in facilities and at home. Programmers should be aware that changing deep rooted practices, such as early bathing in Nigeria, may take time and should utilize the current beliefs in the importance of neonatal warmth to facilitate behaviour change

Correction: A Seroepidemiological Study of Serogroup A Meningococcal Infection in the African Meningitis Belt.

[This corrects the article DOI: 10.1371/journal.pone.0147928.]

Newborn Care: A Qualitative Study of Inter-Cultural Variations and Similarities Among Two Ethnic Groups in Northeastern Nigeria

Background: Neonatal mortality remains unacceptably high in most sub-Saharan and Asian communities, where cultural practices and poor antenatal care are common. Newborn care practices play a key role in preventing neonatal deaths. Aims: This study aimed to examine similarities and variations in newborn care between two major ethnic groups in northeast Nigeria. Subjects And Methods: Qualitative methods involving narratives, observations, focus group discussions, and in-depth interviews were used to collect data from recent mothers (ten per ethnic group) and grandmothers from the Babur/Bura and Kanuri ethnic groups in Borno State, Northeast Nigeria. A snowballing sampling technique was used to select the participants within four communities/villages (two for each ethnic group). Results: Babies were bathed within 30 to 45 minutes after delivery by mothers in both groups, except in case of ill health of the child and/or mother. Various substances were applied to the cord even though hygienic cord-cutting practice was reported. With the exception of early bathing, good thermal care practices were observed in both groups. Both groups applied emollients on the skin of the babies, but Bura preferred the use of shea butter to oils and lotion. Various substances were applied to other parts of the body of the baby, such as the fontanelle (Mahogany oil), anus (Neem oil and Mahogany oil), and circumcision wound (engine oil) more so among the Bura than the Kanuri. None of the substances were deemed to be harmful. Conclusion: Similarities and variations in newborn care exist between the two ethnic groups. There is a need for health education and promotion to encourage and facilitate positive behavioral change from old traditional practices to healthy newborn care practices among the Babur/Bura and Kanuri ethnic groups

Comparison of outcomes of a community-based education program executed with and without active community involvement

Objective : The aim of this study was to evaluate the applicability of a previously designed set of generic objectives for community-based education (CBE) emphasising community involvement. Methods : The study was designed as a non-blinded, randomised trial. Experimental and conventional groups of students following CBE programmes either closely or weakly matching the set of generic objectives were compared. Student groups were subjected to passive participatory observation. Students evaluated their programmes through questionnaires. The impact of student interventions was assessed by community compliance. Community perception of the programmes was evaluated through structured interviews with community representatives. Results : Students in experimental groups appreciated their programme more than students in conventional groups. High compliance and appreciation were recorded in communities hosting the modified programme. Most students in conventional groups judged their posting negatively, largely because of the high number of households to be visited. Health interventions performed by conventional groups lacked co-operation between students and the community. Communities hosting conventional groups felt their health needs were scarcely discussed and addressed. Conclusions The modification of an existing CBE programme to better match a set of generic CBE objectives emphasising community involvement had a positive effect on programme outcomes and levels of appreciation by both students and hosting communities. However, some confounding variables could not be controlled. Colleagues planning comparable studies may take advantage of the lessons we learned while performing this study

Appraisal of parents on pre-marital HIV screening in a rural, northeast community, Nigeria

Sub-Saharan Africa has two-thirds of global HIV/AIDS burden. Nigeria has a prevalence of 4.1%, with transmission mainly through heterosexual intercourse. Sixty percent of new infections with HIV occur within the age group 15-29 years and most marriages especially with respect to females are conducted within this age g" .o. Marriages are usually contracted by parents, therefore their knowledge and attitude to HIV status is deemed important. Objective: To assess the knowledge and attitude of parents towards pre marital HIV Screening. Method: A cross-sectional descriptive study was conducted among 400 randomly selected parents in three districts of Bama Local Government Area (LGA) using a 36 Item structured questionnaire administered to respondents in their homes. Results: A total of 397 respondents (99.3%) have heard of HIV/AIDS, radio (67.3%) being the major source. Sexual intercourse (97.3%), the use of contaminated instruments (42.5%), transmission of infected blood and blood products (17.8%) were identified as modes of transmission. However, only 8.5% identified mother to child transmission. Majority (98.8%)were aware that the disease is preventable mostly through faithfulness to partner (68.8%), premarital abstinence (64.8%) and Condom use (17.5%) while avoidance of contaminated instrument (9%) were also identified as modes of prevention. Majority (96.8%) of parents were aware of pre marital HIV Screening. Majority of the parents (97.7%) approve of premarital HIV screening. Many (87.8%) of parents were not aware of the availability of HIV testing facility. Conclusion: The awareness and knowledge of HIV/AIDS in Bama LGA is high among parents. There was also a high level of awareness of PMHS with a positive attitude of parents toward it