Abstract
Majority of neonatal deaths in developing countries have been associated with inappropriate or poorly practiced newborn care, specifically safe cord care, optimal thermal care and early initiation and practice of exclusive breastfeeding. There is limited information about the quality of these essential newborn care practices in Accra, Ghana. The main objective of this study was to assess the knowledge about and quality of essential newborn care practices (ENC) and determine related factors in La Dade Kotopon Municipal Assembly, Accra, Ghana. A questionnaire-based, cross-sectional study was conducted among 423 mothers and caregivers in two hospitals to assess safe cord care, optimal thermal care and exclusive breastfeeding. Knowledge was assessed using eight statements regarding ENC and categorized as 'Adequate knowledge' and 'Inadequate knowledge' using a composite score. Practices were similarly categorized as 'Good' and 'Poor' ENC. Data were exported from Microsoft Excel into STATA version 15 for statistical analysis. Descriptive statistics were generated and inferential analysis was done using chi-square test and logistic regression to determine factors associated with good ENC at 95% confidence level. All respondents sampled participated in the study. A total of 263 (62%) respondents had adequate knowledge and 308 (73%) respondents practiced appropriate newborn care ('Good' ENC). The likelihood of appropriate newborn care practices was lower among mothers/caregivers who were unemployed (AOR = 0.13, 95% CI: 0.09-0.26), who had a home delivery (AOR = 0.17, 95% CI: 0.11-0.69) and made their first antenatal visit in the third trimester (AOR = 0.02, 95% CI: 0.01-0.35) compared to their counterparts. Knowledge of ENC was not associated with practice in this study. Appropriate newborn care practices were relatively high among the respondents. Improving sources of livelihood and targeted education to encourage early antenatal visits and facility-based births might improve newborn care where it is inadequate.