Background: Non-institutional births remain prevalent in low- and middle-income countries, associated with a majority of adverse maternal and child health outcomes, including maternal and child mortality. Ensuring essential newborn care (ENC) practices for these non-institutional births is crucial for reducing these adverse outcomes. This study aimed to identify the prevalence, and factors associated with the adoption of ENC practices among non-institutional births in urban Bangladesh.
Methods: A total of 2,165 children's data were analyzed, extracted from the 35,186 ever-married women interviewed in the 2021 Bangladesh Urban Health Survey. Six ENC components and their level (lowest/none, moderate, and highest) were considered as the outcome variables. Several socio-demographic factors were considered as the explanatory variables. Multivariate binary and multinomial logistic regression model were used to explore the association between outcome and explanatory variables.
Results: Approximately 49% of all mothers reported practicing the highest level of ENC. Among the individual components, the highest adherence was observed for the use of a disinfected instrument to cut the umbilical cord (90%). The likelihood of adopting the highest level of ENC practices was higher among mothers with relatively higher education and wealth quintiles and lower among those residing in slum and other urban areas of city corporations compared to non-slum areas. Mothers living in the Khulna and Sylhet divisions had a lower likelihood of adopting the highest level of ENC practices.
Conclusion: Awareness building programs are needed to educate the population, particularly mothers, about the importance of practicing ENC for improving maternal and child health outcomes.
Keywords: Bangladesh; Essential newborn care (ENC); neonatal mortality; non-institutional births; urban health; urban slum and non-slum.
Main findings: The likelihood of utilizing the highest level of ENC practices was lower among mothers residing in slum and other urban areas of city corporations compared to those residing in non-slum areas.Added knowledge: Considering the limited studies on this specific topic especially for large-scale data of urban survey, the findings of this study contribute to a better understanding about essential newborns care (ENC) practices in urban areas of Bangladesh, particularly for urban-slum areas.Global health impact for policy and action: Our study contributes to be a better understanding of ENC patterns and which factors influence for ENC practices in adopting evidence-based policies and programmes for improving child health outcomes.