Neonatal morbidity and care-seeking behaviour in two rural areas of Bangladesh

Abstract

Objective: Assess the pattern of neonatal morbidity and subsequent care-seeking behaviour in rural Bangladesh. Methodology: Data were collected from 3,030 women who had livebirths between May 1995 and February 1997 in two rural subdistricts—Abhoynagar and Mirsarai—the field sites of the Operations Research Project of ICDDR,B. The women were interviewed in their homes using a semi-structured questionnaire. Bivariate analysis was done to assess the relationship between the different variables. Results: More than two-thirds of the neonates were reported to have problems. The most common complaint was fever (40%), followed by respiratory distress (25%). Complications during pregnancy were found to be associated with increased neonatal morbidity (p<0.001). About 42% of the women did not seek help from any health service providers when their newborns had problems. Significant sex differential was observed among the male and female neonates for whom services were sought (p<0.001). In majority of the cases (48%), village doctors were consulted, followed by homeopaths in Mirsarai, whereas in Abhoynagar, the opposite trend was seen. Only a negligible percentage attended the government facilities, like Satellite Clinic, Health and Family Welfare Centre, and Thana Health Complex. However, 30% of the mothers consulted private practitioners. It was found that health care-seeking behaviour was associated with mothers' education (p<0.01). Conclusion: The government facilities for neonatal care are under-used, and efforts should be made to raise awareness among mothers regarding this. Steps to reduce maternal morbidity by raising awareness of complications during pregnancy may result in decreased neonatal morbidity.