Primary health workers' knowledge and practices relating to neonatal jaundice in Ibadan, Nigeria

ABSTRACT

Background: Over half of births and newborn care occur in primary healthcare facilities in Nigeria, but information on activities of personnel working there is scarce. Aim: To assess the knowledge and practices relating to neonatal jaundice (NNJ) among community health workers (CHWs) and community birth attendants (CBAs) in Nigeria. Setting: We conducted a cross-sectional survey of all 227 CHWs and 193 registered CBAs in Ibadan, Nigeria.Methods: Knowledge and practices regarding NNJ were measured using a pretested questionnaire. Knowledge and practices were assessed on a 33-point scale and a 13-point scale, respectively. Scores ≤ 17 and ≤ 9 was regarded as poor knowledge and as wrong practice, respectively. Results: Many (64.5%) of the respondents could not correctly describe examination for NNJ (CHWs 49.4%; CBAs 50.6%). Of the 200 (47.6%) who treated NNJ 3 months prior to the study, 62.5% (CHWs 66.9% and CBAs 53.7%) treated NNJ with orthodox drugs. Drugs prescribed included antibiotics (93.3%), antimalarials (5.3%), multivitamins (28.0%), paracetamol (6.2%) and phenobarbitone (7.1%). Significantly more CHWs than CBAs practiced exposure to sunlight (33.1% versus 16.4%) and administration of glucose water (28.6% versus 14.9%), while 58.0% of all respondents referred cases to secondary health facilities. Overall, 80.2% had poor knowledge (CHWs 78.9%; CBAs 81.9%) and 46.4% engaged in wrong practices (CHWs 57.3%; CBAs 33.7%). CHWs were more likely to indulge in wrong practices than CBAs (OR = 2.22, 95% CI = 1.03, 4.79). Conclusion: Primary Health Workers in Ibadan had poor knowledge and engaged in wrong practices about NNJ. The needs to organise regular training programmes were emphasised