TABLE OF CONTENTS
Content Page
Title page i
Certification ii
Dedication iii
Acknowledgements iv
Abstract v
Table of Contents vi
List of Tables vii
List of Figures viii
Appendices ix
CHAPTER
ONE: INTRODUCTION
1.1 Background to the Study 1
1.2 Statement of the Problem 2
1.3 Objective of the Study 3
1.4 Research Questions 3
1.5 Hypotheses 4
1.6 Scope of the Study 4
1.7 Significance of the Study 4
1.8 Justification to the Study 4
1.9 Operational Definition of Terms 5
CHAPTER
TWO: REVIEW OF LITERATURE
2.0 Introduction 6
2.1 Umbilical cord care overview 6
2.2Determinant of umbilical cord practices 6
2.3 Types of substances used for umbilical cord care 8
2.4 Possible problems of umbilical cord stump 8
2.5 World Health Organization (WHO) recommendations 9
2:6:0 Related literatures to umbilical cord care practices 10
2:6:1 Knowledge of mother regarding newborn
umbilical cord care 11
2:6:2
Practice of mothers regarding newborn umbilical cord care12
2:6:3 General management of umbilical cord infection 15
2.1Ramona Mercer: Maternal Role Attainment
Conceptual Model
16
CHAPTER
THREE: METHODOLOGY
3.0 Introduction 18
3.1 Research Design 18
3.2 Population 18
3.3 Sample size and Sampling Technique 18
3.4 Research Instrument 19
3.5 Reliability and Validity of Instrument 20
3.6 Method of Data Collection 20
3.7 Method of Data Analysis 20
3.8 Ethical Consideration 21
CHAPTER
FOUR: DATA ANALYSIS, RESULTS
AND
DISCUSSION OF FINDINGS
4.0 Introduction 22
4.1 Socio-demographic information of respondents 22
4.2 Analysis of Research Questions 27
4.3 Hypothesis Testing 32
4.4 Discussion of Findings 35
CHAPTER
FIVE: SUMMARY, CONCLUSION
AND
RECOMMENDATIONS
5.0 Introduction 39
5.1 Summary 39
5.2 Conclusion 40
5.3 Recommendations 40
5.4 Limitation of the Study 40
5.5 Suggestion for Further Studies 40
REFERENCES 41
APPENDICES 47
LIST OF TABLES
Table Page
4.1 Socio-demographic data of the respondents 23
4.2 Interview guide on knowledge toward umbilical cord care 25
4.3 Interview guide on umbilical cord care practice 26
4.4 Mother’s knowledge on umbilical cord cares 27
4.5Umbilical cord care practices of mothers 27
4.6 Substances/materials used for umbilical cord care 28
4.7 ANOVA table for factors influencing cord practice 29
4.8 Model summary for factors influencing cord practice 29
4.9 Coefficient table for factors influencing cord practice 29
4.10Relationship
between mother’s knowledge and practice of umbilical care 30
4.11 Correlations of knowledge and practice 30
4.12 Mean and standard deviation of knowledge and practice 31
4.13
Relationship between umbilical cord care practice and maternal parity 31
4.14 Correlations of maternal parity and practice 31
4.15Hypothesis One 32
4.16 Correlation of practice and income 32
4.17 Hypothesis Two 33
4.18 Hypothesis Three 34
LIST OF FIGURE
Figure
Page
2.1 Maternal Role Attainment Model by Mercer 17
APPENDICES
Appendix Page
Inform Consent Form 46
Questionnaire used for this study 47
Ethical Clearance Certificate 50
Letter of Introduction 51
Evidence of Anti-plagiarism 52
CHAPTER ONE
INTRODUCTION
The first 28days in the infant’s life is a period of great significance as the newborn is fragile and susceptible to infection; hence they need to be handled carefully so as to prevent neonatal death or permanent deformity. Mothers as the primary care providers have very important role to play to ensure that these newborns develop optimally as the new born health and survival is dependant on the essential care received before, during and after delivery (Joel-Medewase, Oyedeji, Elemile, & Oyedeji, 2008).
Neonatal infection is a major cause of neonatal deaths as the
mortality rate could be as high as 44 per thousand life-births in the
north-east zone of Nigeria. Neonatal deaths, cord infection and sepsis can be
prevented with good umbilical cord practices especially in areas where home
deliveries are done. In developing countries such as Nigeria,
umbilical cord infection accounts for significant number neonatal morbidity and
mortality, this accounts for 276,000 neonatal deaths annually the second
highest deaths in the world and in Nigeria alone it accounts for about 33% of neonatal mortality
(Jabbi,
Shoretire, Ojile, Maishanu &
Orobaton, 2014; Soofi, Cousens, Imdad, Bhutto,
& Ali, 2012; Orobaton, Abegunde,
Abdulazeez, Akomolafe & Ganiyu, 2015; Osuchukwu, 2014).
The
umbilical cord is a tissue that has a vein and two arteries of which at term is
about 56cm in length and extends normally from the center of the placenta to
the umbilicus of the unborn baby. During pregnancy, the umbilical cord connects
the fetus to the mother through the placenta. The umbilical cord is responsible
for the supply of blood rich in nutrients and oxygen from the mother to the
fetus and the removal of carbon dioxide and other metabolites away from the
fetus to the mother. Umbilical cord care is one of the most essential cares
given to umbilical stump of newborns in the first few days of extra uterine
life before the fall-off of the cord and immediately after its fall (Fraser
& Cooper, 2009).
The availability of tetanus vaccine for pregnant women and topical application of antimicrobial agents should help reduce bacterial infection hence newborn deaths and improve the newborn health and wellbeing. Aside cleaning and drying of the umbilical cord stump, daily application of chlorhexidine 7.1% chlorhexidine digluconate aqueous solution or gel to the umbilical cord stump during the first week of life is strongly recommended for newborns who are born at home in settings with high neonatal mortality (30 or more neonatal deaths per 1000 live births) Chlorhexidine digluconate 7.1% gel was used by 36,404 newborns delivered by 36,370 mothers to help reduce such neonatal deaths in Sokoto State, North West Nigeria, this low cost but highly effective gel used for the prevention of newborn sepsis should be made available in all delivery settings so as to reduce umbilical cord infection and then neonatal death (Enang, Ushie, Arikpo, Osonwa, Esu, Odey, et al., 2013; Mullany, Darmstadt & Tielsch, 2003; Orobaton et al., 2015).
Unqualified personnel provide health care services to majority of
women especially during pregnancy, child birth and after child birth as there
is lack of skilled personnel, needed resources and availability of essentialdrugs that has
increased neonatal and childhood deaths. To achieve a healthy and productive
society it is important to pay attention to the health and wellness of the
newborn as this will help reduce neonatal and newborn mortality and morbidity.
In 2013, in Johannesburg, South Africa, an International Conference on Maternal,
Newborn and Child Health was held so as to bring about concrete actions for
improving MNCH in Africa. Maternal and child care during pregnancy, child birth and post partum is
a major strategy to improve child survival as low socio-cultural barriers to
care, weak health care system and poor socio-economic development influence
maternal and child health (Ezechi & David,
2012)
The
future of any nation lies on the present generation, their health and welfare
can be altered by activities that occur either before, during or after
delivery. Newborn health and survival is partly dependent on the mother’s
decisions on where to deliver and actions or activities taken after delivery.
In most rural communities, deliveries and child care activities are mostly
managed at home where about 69.8% of care providers used unhygienic and harmful materials for
cord care (Osuchukwu, 2014).
In Nigeria, cases of umbilical cord infections are under documented and reported. But for some studies conducted in the hospital, in Port Harcourt, omphalitis constitute 10% reasons of neonatal admissions and 30% of neonatal deaths. In Ibadan it constitute about 18% of neonatal deaths while in Calabar, 49% of neonatal deaths were linked to omphalitis. Neonatal death every year in Nigeria is about 241,000 making it the highest neonatal death rate in African. In Africa, annually about 600,000 infants die of neonatal tetanus. Global annual neonatal deaths constitute about 4million (3.1%) and about (25%) of these deaths are due to umbilical infection. Similar studies have been conducted in other part of the country so the researcher intends to explore the factors influencing umbilical cord care Plateau state, due to the increasing number of mothers returning to the health care facility with umbilical cord complications especially omphalitis in newborns (Federal Ministry of Health, 2009; Osuchukwu, 2014).
1.3 Objective of the study
The general objective is to assess the factors influencing umbilical cord care practices among mothers attending infant welfare clinic in selected primary health care centres in Jos-North Local Government Area, Plateau State. The specific objectives are to:
FACTORS INFLUENCING UMBILICAL CORD CARE PRACTICES AMONG MOTHERS ATTENDING INFANT WELFARE CLINIC IN SELECTED PRIMARY HEALTH CARE CENTRES IN JOS-NORTH LOCAL GOVERNMENT AREA, PLATEAU STATE
