Knowledge and Practice of Umbilical Cord Care among Postnatal Mothers in Zonal Hospital, Okrika, Rivers State, Nigeria

Abstract

Background: Cord infections account for 10 – 19% of neonatal admissions in Nigeria. Although WHO has recommended the use of Chlorhexidine gel on the umbilical stump, many postnatal mothers in Rivers State still apply substances harmful to the umbilical stump either in conjunction with or instead of the recommended antiseptic.

Objective: The aim was to evaluate the knowledge of the importance of the care of the umbilical cord, the substances used and the factors that influence cord care choices among postnatal mothers in Zonal hospital, Okrika.

Methods: descriptive cross sectional design. A total of 118 postnatal mothers were accidentally selected after 6 weeks of delivery. A total of 118 questionnaires were issued and 107 were returned (91% return). The Pearson reliability coefficient for the instrument with 26 items, KPDPMUCCQ was 0.910. All data were analysed by frequency, percentage, mean and standard deviation (cut-off = 1.50) and Chi square tests at 95% confidence interval.

Results: Knowledge very high (grand mean = 1.88). 100% (107 mothers) agreed to keep the cord out of the diaper. Close up toothpaste/methylated spirit (77.6%), herbal solutions (74.8%), Blue Sea Vaseline after stump detachment (97.2%) and penicillin ointment (85.1%) were other concurrent practices used with chlorhexidine gel. The two most important factors for choosing the substance were perceived effectiveness (86.0%) and availability/accessibility (79.4%). The most influential source was health workers (88.8%) followed by family members (76.6%), friends (71.0%) and TBAs (65.4%). Educational background significantly predicted both knowledge (χ² = 12.847, p = 0.005) and substance choice (χ² = 16.847, p = 0.001). The variables tested under H₀₃ – the four factors – were all significant at p ≤ 0.001.

Conclusions: High knowledge levels and almost universal uptake of Chlorhexidine are in parallel with the high prevalence of concurrent use of harmful substances, thus highlighting the knowledge-practice gap that education cannot address. To tackle it, messages about cord care need to be disseminated to families, TBAs, and ensure commodity availability at the facility and community levels.