Immediate and early postnatal care for mothers and newborns in rural Bangladesh.

The study evaluated the impact of essential newborn-care interventions at the household level in the Saving Newborn Lives project areas. Two household surveys were conducted following the 30-cluster sampling method using a structured questionnaire in 2002 (baseline) and 2004 (endline) respectively. In total, 3,325 mothers with children aged less than one year in baseline and 3,110 mothers in endline from 10 sub-districts were interviewed during each survey. The proportion of newborns dried and wrapped immediately after birth increased from 14% in 2002 to 55% in 2004; 76.2% of the newborns were put to the mother's breast within one hour of birth compared to 38.6% in baseline. Newborn check-up within 24 hours of delivery increased from 14.4% in 2002 to 27.3% in 2004. Postnatal check-up of mothers by trained providers within three days of delivery rose from 2.4% in 2002 to 27.3% in 2004. Knowledge of the mothers on at least two postnatal danger signs increased by 17.2%, i.e. from 47.1% in 2002 to 64.3% in 2004. Knowledge of mothers on at least three postnatal danger signs also showed an increase of 16%. Essential newborn-care practices, such as drying and wrapping the baby immediately after birth, initiation of breastmilk within one hour of birth, and early postnatal newborn check-up, improved in the intervention areas. Increased community awareness helped improve maternal and newborn-care practices at the household level. Lessons learnt from implementation revealed that door-to-door visits by community health workers, using community registers as job-aids, were effective in identifying pregnant women and following them through pregnancy to the postnatal periods.