ABSTRACT
Harmful practices by birth attendants during and shortly after birth, and poor practice in the home during the first week of life, may contribute to high neonatal mortality rates in Egypt. Inability of birth attendants and mothers to identify neonatal danger signs is also an issue. In this study 217 recently-delivered mothers were interviewed about their delivery and home care practices. Some good delivery care practices were identified, including routine hand-washing by most birth attendants, sterile umbilical cord care in most cases, and postnatal visits from the birth attendant in most cases. However, a number of deficits in care and potentially harmful practices were found: poor aseptic procedures, delivery of one-third of women with complications in the home; pulling on the umbilical cord to hasten delivery of the placenta and hanging the neonate upside-down by the legs during resuscitation. Some postnatal care practices were in also accord with generally agreed-upon standards of care, such as prompt initial feeding, feeding of colostrums and most bathing practices. Substandard care practices among mothers were: a lack of hand-washing before neonatal care; lack of exclusive breastfeeding including supplemental feeds to half of newborns at the first feeding; and a lack of aseptic cord care. The mothers' assessment of the health of their newborns was in good agreement with the incidence of signs of potentially serious illnesses, suggesting that advice they received has been appropriate. Based on these findings, priorities for future investigation are proposed