Traditional beliefs and practices regarding new born care, care seeking behaviour of families, infrastructure available and knowledge of health care providers for the care of sick neonates in states with high and low neonatal mortality rates. By

Background & Objectives Status of child health indicates growth of any nation. India contributes to nearly 25% of the total 3.9 million neonatal deaths worldwide. Neonates fall sick despite of precautions and care, especially in resource poor settings. Literature suggests that traditional practices and care seeking behaviours of families influence neonatal morbidity and mortality. The present study was undertaken to describe the traditional beliefs and practices related to newborn care, describe care seeking behaviour of families for their sick neonates and to identify the factors influencing care seeking behaviour of families for sick neonates in states with high and low Neonatal Mortality Rate (NMR). Other aim was to describe the infrastructure available for care of sick neonates, at different levels of health care, and to compare the knowledge of health care providers regarding management of sick neonates in states with high and low NMR. Methods Traditional beliefs, practices and care seeking behaviours of families during neonatal illnesses was assessed by a macroethnographic approach, among thirty family primary care givers (PCGs) each from Mathura District in Uttar Pradesh (NMR:40) and Alapuzha district in Kerala (NMR:7), recruited by maximum variation sampling followed by purposive sampling. In-depth interviews, focus group discussions and unstructured observations were conducted to elicit data and anlaysed using Spradley’s method of ethnographic data analysis. Xii Infrastructure available and knowledge of health care providers for the management of sick neonates was assessed by a descriptive comparative survey. The number of health care facilities included by total enumeration sampling from Mathura and Alapuzha were: District Hospitals (DH): 2, 2; Tehsil Hospitals (TH): 0, 3; Community Health Centres (CHC): 6, 8; Primary Health Centre (PHC): 19, 36; Sub Centres (SC): 116; 197 respectively. The number of health care providers recruited from Mathura and Alapuzha, respectively were medical officers (32, 101), staff nurses (13, 145) and Auxillary Nurse Midwives (ANM) (113, 235). Data were collected using a validated health facility assessment checklist based on Indian Public Health Standards (IPHS) and a validated knowledge assessment proforma based on Integrated Management of Neonatal and Childhood Illnesses (IMNCI) guidelines (r=0.95), and analysed using measures of central tendency, frequencies, percentages and Mann Whitney U test using SPSS -15.