Factors associated with adoption of beneficial newborn care practices in rural Eastern Uganda: a cross-sectional study

BACKGROUND: Beneficial newborn care practices can improve newborn survival. However, little is known about the factors that affect adoption of these practices. METHODS: Cross-sectional study conducted among 1,616 mothers who had delivered in the past year in two health sub-districts (Luuka and Buyende) in Eastern Uganda. Data collection took place between November and December 2011. Data were collected on socio-demographic and economic characteristics, antenatal care visits, skilled delivery attendance, parity, distance to health facility and early newborn care knowledge and practices. Descriptive statistics were computed to determine the proportion of mothers who adopted beneficial newborn care practices (optimal thermal care; good feeding practices; weighing and immunizing the baby immediately after birth; and good cord care) during the neonatal period. We conducted multivariable logistic regression to assess the covariates of adoption of all beneficial newborn care practices. Analysis was done using STATA statistical software, version 12.1. RESULTS: Of the 1,616 mothers enrolled, 622 (38.5%) were aged 25-34; 1,472 (91.1%) were married; 1,096 (67.8%) had primary education; while 1,357 (84%) were laborers or peasants. Utilization of all beneficial newborn care practices was 11.7%; lower in Luuka (9.4%, n = 797) than in Buyende health sub-district (13.9%, n = 819; p = 0.005). Good cord care (83.6% in Luuka; 95% in Buyende) and immunization of newborn (80.7% in Luuka; 82.5% in Buyende) were the most prevalent newborn care practices reported by mothers. At the multivariable analysis, number of ANC visits (3-4 vs. 1-2: Adjusted (Adj.) Odds Ratio (OR) = 1.69, 95% CI = 1.13, 2.52), skilled delivery (Adj. OR = 2.66, 95% CI = 1.92, 3.69), socio-economic status (middle vs. low: Adj. OR = 1.57, 95% CI = 1.09, 2.26) were positively associated with adoption of all beneficial newborn care practices among mothers. CONCLUSION: Adoption of all beneficial newborn care practices was low, although associated with higher ANC visits; middle-level socio-economic status and skilled delivery attendance. These findings suggest a need for interventions to improve quality ANC and skilled delivery attendance as well as targeting of women with low and high socio-economic status with newborn care health educational messages, improved work conditions for breastfeeding, and supportive policies at national level for uptake of newborn care practices.