Newborn Health

Care for Newborn Illness

Caregivers seek prompt and appropriate care for signs and symptoms of newborn illness

Prompt diagnosis and appropriate care for newborn illness could reduce neonatal mortality by up to 30%.1Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost?
The Lancet
Zulfi qar A Bhutta, Jai K Das, Rajiv Bahl, Joy E Lawn, Rehana A Salam, Vinod K Paul, M Jeeva Sankar, Hannah Blencowe, Arjumand Rizvi, Victoria B Chou, Neff Walker
2014
This is an occasional behavior that needs to be practiced without hesitation at the onset of danger signs of illness.

Key Points from Global Research

  • Emphasizing caregiver knowledge and self-efficacy to recognize the danger signs of newborn illness and acknowledge the seriousness can ensure immediate care-seeking for newborns.  
  • Working within local structures to address social norms that define many practices in the first weeks of life can ensure families do not delay in seeking care for sick newborns.

Behavior Profile Sample: Care for Newborn Illness

A Behavior Profile is a summary analysis of each behavior. This sample draws from global evidence and illustrates the result of using the Create Behavior Profiles Tool to analyze factors, supporting actors and strategies and to ensure logical pathways exist between strategies proposed and factors related to the practice of the behavior. This sample may be used as a starting point or reference for creating country-specific Behavior Profiles.

CREATE Country-specific Behavior Profiles

Improve maternal and child survival
Caregivers seek prompt and appropriate care for signs and symptoms of newborn illness
Percentage of last births in the two years preceding the survey who had their first postnatal checkup in the first two days after birth. The proxy indicator is based on the assumption that caregivers who attend a postnatal checkup within the first two days are more likely to know the danger signs of newborn illness and take action, and are also accessing care during a child's most vulnerable days.

Behavior Analysis

Strategy

STEPS

What steps are needed to practice this behavior?
  1. Recognize signs and symptoms of newborn illness
  2. Mobilize transport, resources and logistics to get to a qualified provider
  3. Obtain care from a qualified provider
  4. Adhere to full course of prescribed treatment
  5. Continue breastfeeding

Click on any box
        to see the pathwaysA pathway illustrates how elements in the Behavior Profile are linked. When read from right to left, a pathway highlights how strategies are expected to address the factors to enable adoption of the Accelerator Behavior.  
        of the behavior.

FACTORS

What factors may prevent or support practice of this behavior? These should be analyzed for each country context.
Structural
Accessibility: Households are far from facilities, especially those which can provide care at all hours
Accessibility: Many women deliver at home and therefore miss critical signs of distress in first hours of newborn's life
Provider Competencies: Lack of continuum of care between antenatal care, delivery, postpartum and newborn periods reduces attention paid to child
Provider Competencies: Some caregivers have a low perception of the quality of care they will receive at the clinic and prefer traditional medicine options
Social
Norms: Some cultures have strict beliefs and practices relating to the first weeks of a newborn's life including the woman leaving the home or taking the newborn out of the home
Internal
Attitudes and Beliefs : Some medications (antibiotics) cause side effects that are not well-understood by and are worrisome to caregivers
Attitudes and Beliefs : Families want a healthy baby
Knowledge: Caregivers do not always understand how quickly small problems can become major issues in a newborn and they do not always recognize the early signs and symptoms of serious newborn illnesses

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior?
Institutional
Policymakers: Ensure clear linkages between maternal and newborn care and establish protocols for community-based postpartum and newborn home visits
Providers: Offer counseling and support to pregnant women on newborn care and care-seeking at all touch points during pregnancy, delivery and in the first month of life
Household
Family Members: Learn signs and symptoms of newborn illnesses and encourage new mothers to feel comfortable in seeking skilled care for their infants
Male Partners: Actively participate in ANC and support partner in learning about newborn care and care-seeking including planning for transport when and if it is required

POSSIBLE PROGRAM STRATEGIES

How might we focus our efforts based on this analysis?
Enabling Environment
Policies and Governance: Ensure linkages between newborn health and postpartum care for mothers including community-based care options and home visits
Systems, Products and Services
Quality Improvement: Ensure clinics and providers adhere to rigorous quality standards including provision of counseling on drug side-effects and adherence
Demand and Use
Communication and Mobilization: Provide education for caregivers during antenatal and postpartum visits on newborn illness and danger signs, including plans for emergencies
Communication and Mobilization: Explore use of mobile phones and other innovative reminder materials to check in with new mothers in the first days post partum
Communication and Mobilization: Engage husbands and family members in outreach and education during pregnancy to plan support for the new mother and baby
Skills Building: Train TBAs or CHWs to conduct home visits with new mothers on day 1 and 3 of a baby's life to monitor the health of both mother and baby and provide referrals and counseling

Global Status of Accelerator Behavior

Percentage of last births in the two years preceding the survey who had their first postnatal checkup in the first two days after birth. The proxy indicator is based on the assumption that caregivers who attend a postnatal checkup within the first two days are more likely to know the danger signs of newborn illness and take action, and are also accessing care during a child's most vulnerable days.

The DHS Program Indicator Data API, The Demographic and Health Surveys (DHS) Program

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