ASSESSMENT OF UMBILICAL CORD CARE GIVEN BY TRADITIONAL BIRTH ATTENDANTS IN OGHARA ETHIOPE WEST LGA NORTH LOCAL GOVERNMENT AREA

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CHAPTER ONE—————————————————————————1

INTRODUCTION—————————————————————————–1

Background of study———————————————————————-1

Aim/Purpose of study——————————————————————–2

Statement of problem———————————————————————3

Broad objective of the study————————————————————-3

Specific objective————————————————————————3

Significance of study——————————————————————–3

Scope of study / delimitation ———————————————————-3

Operational definition of terms——————————————————–4

CHAPTER TWO

Literature review—————————————————————————5

Conceptual framework——————————————————————-22

Hypothesis ———————————————————————————24

CHAPTER THREE

MATERIALS AND METHODS

Research design————————————————————————–26

Research site and setting—————————————————————-26

Research population ——————————————————————–26

Sample and sampling techniques——————————————————27

Instrument for data collection———————————————————-27

Validity/reliability ———————————————————————–27

Method of data collection—————————————————————28

Procedure for data analysis————————————————————-28

Ethical consideration——————————————————————–28

CHAPTER FOUR

RESULT———————————————————————————–29

Data analysis and interpretation———————————————————30

Testing of hypothesis———————————————————————-41

CHAPTER FIVE

DISCUSSION OF FINDINGS————————————————————44

Discussion of findings———————————————————————44

Nursing implication————————————————————————46

Summary ———————————————————————————–47

Conclusion———————————————————————————-47

Recommendation—————————————————————————47

References ———————————————————————————49

Appendix ———————————————————————————-52

                                                      ABSTRACT

Proper care of the umbilical cord is very important to avoid sepsis in the life of the neonates. This study was on Assessment of Umbilical Cord Care given by Traditional Birth Attendants in OgharaEthiope West LGA. 92 open and closed ended structured questionnaires were administered and 82 were retrieved successfully which wereanalyzed to all the TBAs in Oghara community. The findings revealed that 57 (69.51%) of the respondents do not know about cord care while 25 (30.49%) knows of cord care. This Shows that majority of the TBA are not informed on appropriate care of the umbilical area of a new born.. The hypothetical statements was tested using chi-square.  A theoretical value of 3.3which was found higher than the computed value which showed that there is significant relationship between the knowledge of TBAs on cord and their practice on cord care. The data analyzed were compared with the empirical works for similarities and dissimilarities; Reasons for Identified dissimilarities were discussed. Based on the findings,  itwas recommended that the government should empower the TBAs by providing funds to support them to organize seminars and workshops on relevant  issues that concern their  maternal and child health care.

 

 CHAPTER ONE

INTRODUCTION

 

Background of the Study

Umbilical cord is the lifeline of the fetus and of the neonate in the first few minutes immediately after birth. Care of the cord and stump during neonatal period varies according to the social, cultural, economic and geographical factors. Measures take to ensure sterility in cutting and tying the umbilical cord may prevent cord infection (Mullay, 2005). Clean umbilical cord care is accomplished by the maintenance of aseptic technique so that the umbilical cord is uncontaminated by pathogens.At birth, hands should be washed with clean water and soap before tying and cutting the cord. The newborn should be laid on a clean surface and the cord should be cut with a sterile instrument. In the postnatal period, routine cord care includes washing hands with clean water and soap before and after care and keeping the cord dry and exposed to air or loosely covered with clean clothes. The napkin should be folded below the umbilicus. Touching the cord, applying unclean substances to it and covering it with bandages should be avoided. Every year globally, an estimated 4 million infants die and approximately two-third of all these deaths occur in the neonatal period (NNHS, 2004). A substantial proportion of neonatal deaths from infection are due to cord infections (WHO, 2004). Nepal has one of the highest neonatal mortality ratesin the world which is 34 per 1,000 live births. Neonatal Mortality Rates currently accounts two thirds of all infant mortality (MoHP, New ERA and Measure DHS, 2006).

Since the adoption of the primary health care approach in Nigeria in 1979, the three tiers of government (federal, state and local government levels) have accepted the idea of the need to integrate Traditional Birth Attendants into PHC. TBAs presently deliver majority of women in Nigeria as in other developing countries. It is estimated that between 60 and 80% of all deliveries in the developing countries occur outside modern health care facilities, with a significant proportion of this attended to by TBAs (WHO, 2004). Traditionally African births, including prenatal and postnatal care, take place at home, supervised by at least one older, trusted female member of the family or community.. The influence and acceptability of these females, known as Traditional Birth Attendants (TBAs) continue to exist amongst people in remote rural areas and even when formal health services are available. Thus the evaluation of the care of cord stump by TBA is essential in primary health care (Davies, Yin Nu, Oum and Waisi, 2012)

TBAs cannot, however, be automatically incorporated with western health care. Some authors have observed flaws in the practice of TBAs such as poor hygienic practices and infection control, for example, lack of hand washing, unsafe cutting of the cord threatening the safety of the baby, interference with labour, and harmful traditional practices such as taking oxytocic agents (http://www.mariestopes.org.uk/ case studvl.html; Sahachowdhury, 2009).

Immediately after the baby is born, the cord is cut with an instrument by a Traditional birth attendant using the following; bark of a bamboo or a hard and sharp stalk of a plant, razor blade, two sharp stones between the cord is crushed, scissor, etc. hygienic precautionary measures are not always observed. Traditionally, one of the following materials may be applied to the stump of the umbilical cord, also scraping from a coconut shell, cow dung, ashes from the heart of the stones.etc

Poor care and assessment of umbilical cord by traditional birth attendant have been the major factors causing child mortality after birth, thus the researcher was prompted to carry out a research to determine the assessment of umbilical cord care among traditional birth attendants in OgharaEthiope West L.G.A Delta State