Abstract
Objective:
A major factor contributing to neonatal and maternal infections is unhygienic delivery practices. This study explores the impact of clean delivery kit (CDK) use on clean delivery practices during home and facility deliveries.
Design:
Kits were distributed from primary care facilities and mothers and birth attendants received training on kit importance and use. The study was designed as a cross-sectional cohort study. Raedat (community health workers) visited 349 women during the postpartum period to administer a structured questionnaire.
Setting:
The study was conducted from mid-March through mid-July 2001 in two rural areas of Ihnasia district in Beni Suef Governorate (Upper Egypt).
Result:
In bivariate analysis, CDK users in the home were more likely to report that the birth attendant had clean hands (P<0.001), washed/wiped the mother's perineum (P<0.001), used a sterile cord tie (P=0.001), applied antiseptic to the cord after cutting (P<0.001), and used a sterile cord cover (P<0.001) as compared with non-CDK users. CDK users at the facility were more likely to report that the birth attendant washed/wiped the mothers perineum (P=0.049) and used a sterile cord cover (P=0.030) as compared with non-CDK users.
Conclusion:
In settings in which unhygienic practices during home as well as facility deliveries are prevalent, use of inexpensive CDKs can promote clean delivery practices.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Hussein J, Fortney JA . Puerperal sepsis and maternal mortality: what role can new technologies play? Int J Gynecol Obstet 2004; 85 (1): S52–S61.
Koblinsky M, Matthews Z, Hussein J, Mavalankar D, Mridha MK, Anwar I et al. Going to scale with professional skilled care. Lancet 2006; 368: 1377–1386.
Lawn JE, Cousens S, Zupan J . Lancet Neonatal Survival Steering Team. 4 million neonatal deaths: When? Where? Why? Lancet 2005; 365 (9462): 891–900.
Mullany LC, Darmstadt GL, Khatry SK, Katz J, LeClerq SC, Shrestha S et al. Topical applications of chlorhexidine to the umbilical cord for prevention of omphalitis and neonatal mortality in southern Nepal: a community-based, cluster randomized trial. Lancet 2006; 367: 910–918.
Mullany LC, Darmstadt GL, Katz J, Khatry SK, LeClerq SC, Adhikari RK et al. Development of clinical sign based algorithms for community based assessment of omphalitis. Arch Dis Child 2006; 91 (2): F99–F104.
Stoll BJ . The global impact of neonatal infection. Clin Perinatol 1997; 24: 1–21.
WHO. Care of the Umbilical Cord 1998. World Health Organization: Geneva.
Mullany LC, Darmstadt GL, Katz J, Khatry SK, LeClerq SC, Adhikari RK et al. Risk factors for umbilical cord infection among newborns of southern Nepal. Am J Epidemiol 2007; 165 (2): 203–211.
Tsu V . Evaluation of the Health Impact of Clean Home Delivery Kit 2000. Program for Appropriate Technology in Health (PATH) and United States Agency for International Development (USAID): Nepal. p. 36.
Kapoor SK, Reddaiah VP, Lobo J . Control of tetanus neonatorum in a rural area. Indian J Pediatr 1991; 58 (3): 341–344.
Nessa S, Arco E, SKabir IA . Birth kits for safe motherhood in Bangladesh. World Health Forum 1992; 13 (1): 66–69.
Johiko AH, Winter HR, Cheng KK . An intervention involving traditional birth attendants and perinatal and maternal mortality in Pakistan. N Engl J Med 2005; 352 (20): 2091–2099.
Mosha F, Winani S, Wood S, Changalucha J, Ngasalla B . Evaluation of a clean delivery kit intervention in preventing cord infection and puerperal sepsis among neonates and their mothers in rural Mwanza Region, Tanzania. Tanzania Res Bull 2005; 7 (3): 185–188.
Darmstadt GL, Hassan M, Balsara ZP, Winch PJ, Gipson R, Santosham M . Impact of clean delivery kit use on newborn umbilical cord and maternal puerperal infections in Egypt. J Health Popul Nutr 2009 (in press).
Beun MH, Wood SK . Acceptability and use of clean delivery kit in Nepal: a qualitative study. J Health Popul Nutr 2003; 21 (4): 367–373.
El-Zanaty F, Way A . Egypt Demographic and Health Survey 2005 2006. Ministry of Health and Population, National Population Council, El-Zanaty Associates, and ORC Macro: Cairo.
MOHP. National Maternal Mortality Study: Egypt, 2000, Directorate of Maternal and Child Health, Editor. 2001. Ministry of Health and Population: Cairo.
Campbell O, Gipson R, Mohandes AE, Issa AH, Matta N, Mansour E et al. The Egypt national perinatal/neonatal mortality study 2000. J Perinatol 2004; 24: 284–289.
JSI. Rapid Assessment for Clean Delivery in a District in Beni Suef Governorate: A Descriptive Study. 2000. John Snow Incorporated Healthy Mother/Healthy Child Results Package: Cairo.
Darmstadt GL, Hussein MH, Winch PJ, Haws R, Lamia A, El-Said MA et al. Rural Egyptian birth attendant practices during the antenatal, intrapartum, and early neonatal periods. J Health Popul Nutr 2008; 26: 36–45.
Darmstadt GL, Husein MH, Winch PJ, Lamia M, El-Said MA, Haws R et al. Neonatal home care practices in rural Egypt during the first week of life. Trop Med Int Health 2007; 12 (6): 783–797.
Winch PJ, Husein MH . Pilot Testing of Interventions to Promote Compliance with Standard Infection Control Procedures by Health Care Providers. 2000. John Snow Incorporated Healthy Mother/Healthy Child Results Package: Cairo.
Acknowledgements
This study was supported by USAID through the Healthy Mother Healthy Child Results Package Grant to John Snow, Inc., Cairo, Egypt.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Balsara, Z., Hussein, M., Winch, P. et al. Impact of clean delivery kit use on clean delivery practices in Beni Suef Governorate, Egypt. J Perinatol 29, 673–679 (2009). https://doi.org/10.1038/jp.2009.80
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1038/jp.2009.80
Keywords
This article is cited by
-
Supply kits for antenatal and childbirth care: a systematic review
Reproductive Health (2017)
-
A study to evaluate the acceptability, feasibility and impact of packaged interventions (“Diarrhea Pack”) for prevention and treatment of childhood diarrhea in rural Pakistan
BMC Public Health (2013)
-
Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect
BMC Public Health (2011)