ArticleBMC pediatrics2025
Cord care practices and related outcomes among caregivers in two referral facilities in Ghana: a cross-sectional study.
Article in BMC pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundNeonatal mortality is still high in Ghana and Sub-Saharan Africa though great strides have made in other parts of the world. Neonatal infection causes a third of neonatal deaths. The umbilical stump can be an entry point for bacteria if not properly cared for, leading to omphalitis and sepsis. The World Health Organisation and Ghana Health Service recommend using a once daily application of 7.1% chlorhexidine digluconate for cord care for all babies to reduce the incidence of cord complications. There is however, inadequate data on its usage and cord outcomes compared to other cord care methods. This study aimed to assess the risk of cord complications with the various cord care practices in two referral facilities in the Ashanti region, Ghana.
methodsA cross-sectional study with a quantitative approach was conducted from June to December 2023. Simple random sampling was used to select 453 caregivers visiting the two facilities with babies aged 1week to 1 year. We collected data on cord care practices and outcomes using a questionnaire. Stata/SE Version 17.0 was used to analyse the data.
resultsThe 453 caregivers included in this study had a mean age of 29.8 years (± 5.3), and nearly all (99.6%) attended antenatal care. Most (89.8%) used methylated spirit for cord care, while 3.3% used chlorhexidine and 0.9% practiced dry cord care. Reported adverse outcomes included cord infection (3.5%), bleeding (2.9%), and granuloma (0.4%). Among babies whose caregivers used methylated spirit for cord care, 0.5% developed cord granuloma and 3.2% experienced cord bleeding, whereas no such outcomes were reported in the chlorhexidine group. Antenatal care attendance (aOR = 0.03, 95% CI: 0.00-0.56) and handwashing before cord care (aOR = 0.20, 95% CI: 0.04-0.98) were associated with reduced odds of cord infection, while non-health worker recommendations were associated with an increased odds of cord bleeding (aOR = 42.0, 95% CI: 2.45-720.21). Recall bias was a limitation of the study since caregivers of children between one week and one year were required to report cord practices and outcomes in the first few weeks of their babies' lives.
conclusionsThe cord outcome differs with the various cord care practices. Antenatal clinic attendance should be encouraged, and education on proper cord care practices should be intensified among caregivers. Randomized control trials or cohort studies should be done to compare the cord outcome in chlorhexidine and methylated spirit.
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