Pattern and predictors of maternal care-seeking practices for severe neonatal jaundice in Nigeria: a multi-centre survey
Date
2014-04-28
Authors
Ezeaka, C.V.
Ugwu, R.O.
Mukhtar-Yola, M.
Ekure, E.N.
Olusanya, B.O.
Journal Title
Journal ISSN
Volume Title
Publisher
BioMed Central
Abstract
Background: Nigeria is frequently associated with disproportionately high rates of severe neonatal jaundice (NNJ)
underpinned by widespread Glucose-6-phosphate dehydrogenase (G6PD) deficiency. Timely and appropriate
treatment of NNJ is crucial for preventing the associated morbidity and neuro-developmental sequelae. Since mothers
are likely to be the first mostly to observe the onset of severe illness in their newborns, we set out to identify the pattern
and predictors of maternal care-seeking practices for NNJ in three culturally-distinct settings in Nigeria.
Methods: A multi-centre study was conducted among women attending antenatal clinics in Abuja, Lagos and Port
Harcourt from October 2011 to April 2012 using a pretested questionnaire. Predictors of awareness of NNJ, accurate
recognition of NNJ, use of potentially harmful therapies and preference for future hospital treatment were determined
with multivariate logistic regressions.
Results: Of the 488 participants drawn from the three locations, 431 (88.3%) reported awareness of NNJ, predominantly
(57.8%) attributable to professional health workers. A total of 309 (63.3%) mothers with prior knowledge of NNJ claimed
they could recognise NNJ, but 270 (87.4%) from this group accurately identified the features of NNJ. Multiparous
mothers (Adjusted odds ratio, AOR:4.05; 95% CI:1.75-9.36), those with tertiary education (AOR:1.91; CI:1.01-3.61), and those residing in Lagos (AOR:2.96; CI:1.10-7.97) were more likely to have had prior knowledge of NNJ. Similarly,
multiparous mothers (AOR:2.38; CI:1.27-4.46) and those with tertiary education (AOR:1.92; CI:1.21-3.05) were more
likely to recognise an infant with jaundice accurately. Mothers educated by health workers were 40% less likely to
resort to potentially harmful treatment for NNJ (AOR:0.60; CI:0.39-0.92) but more likely to seek hospital treatment in
future for an infant suspected with jaundice (AOR:1.88; CI:1.20-2.95).
Conclusions: Women with tertiary education and multiparous mothers who attend routine antenatal clinics are more likely
than less educated women, to be associated with appropriate care-seeking practices for infants with NNJ regardless of the socio-cultural setting. Systematic efforts by professional health workers are warranted, as part of routine antenatal care, to engage other groups of mothers especially those likely to indulge in self-use of potentially harmful therapies.
Description
Staff publications
Keywords
Neonatal jaundice, , Newborn care , Health-seeking behaviour , Health promotion , Haemolytic agents , Self-medication , Developing countries
Citation
Ezeaka CV, Ugwu RO, Mukhtar-Yola M, Ekure EN, Olusanya BO. Pattern and predictors of maternal care-seeking practices for severe neonatal jaundice in Nigeria: a multi-centre survey