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BMC International Health and Human Rights

, 14:12

Healthcare practices, education, and development


BackgroundInfections account for up to a half of neonatal deaths in low income countries. The umbilicus is a common source of infection in such settings. This qualitative study investigates practices and perspectives related to umbilical cord care in Ethiopia.

MethodsIn-depth interviews IDI were conducted in a district in each of the four most populous regions in the country: Oromia, Amhara, Tigray and Southern Nations, Nationalities and Peoples Region SNNPR. In each district, one community was purposively selected; and in each study community, IDIs were conducted with 6 mothers, 4 grandmothers, 2 Traditional Birth Attendants and 2 Health Extension Workers HEWs. The two main questions in the interview guide related to cord care were: How was the umbilical cord cut and tied? Was anything applied to the cord stump immediately after cutting-in the first 7 days? Why was it applied-not applied?

ResultsThe study elucidates local cord care practices and the rational for these practices. Concepts underlying cord tying practices were how to stem blood flow and facilitate delivery of the placenta. Substances were applied on the cord to moisturize it, facilitate its separation and promote healing. Locally recognized cord problems were delayed healing, bleeding or swelling. Few respondents reported familiarity with redness of the cord - a sign of infection. Grandmothers, TBAs and HEWs were influential regarding cord care.

ConclusionsThis study highlights local rationale for cord practices, concerns about cord related problems and recognition of signs of infection. Behavioral change messages aimed at improving cord care including cleansing with CHX should address these local perspectives. It is suggested that HEWs and health facility staff target mothers, grandmothers, TBAs and other community women with messages and counseling.

KeywordsUmbilical cord care Newborns Infection Ethiopia AbbreviationsCHXChlorohexidine

HEWHealth extension worker

IDIIn-depth interview

SNNPRSouthern Nations, Nationalities and Peoples Region

TBATraditional birth attendant.

Electronic supplementary materialThe online version of this article doi:10.1186-1472-698X-14-12 contains supplementary material, which is available to authorized users.

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Autor: Yared Amare


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