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Influence of Essential Newborn Care Education on Newborn Care Practices among Mothers in Nigeria

Abstract

Essential newborn care is important for promoting newborn survival, preventing avoidable complications, and supporting healthy growth and development during the early neonatal period. Mothers are central to newborn care because many essential practices are performed at home following childbirth. Appropriate essential newborn care includes maintaining thermal protection, initiating and supporting breastfeeding, maintaining hygienic cord care, recognizing newborn danger signs, promoting appropriate immunization, ensuring appropriate postnatal care, and seeking timely healthcare when illness or complications occur. Essential newborn care education provides mothers with relevant information and practical guidance on breastfeeding, thermal care, hygienic cord care, newborn hygiene, infection prevention, immunization, postnatal care, recognition of danger signs, safe newborn handling, and appropriate healthcare-seeking. Newborn care practices refer to the actions undertaken by mothers to promote the health, safety, and wellbeing of their newborns during the early postnatal period. In Nigeria, inappropriate newborn care practices may be associated with inadequate maternal knowledge, cultural beliefs, misconceptions, limited access to maternal and newborn health information, financial constraints, limited postnatal support, and inadequate access to quality healthcare services. Effective essential newborn care education may improve mothers' knowledge, confidence, and ability to implement recommended newborn care practices at home. Against this background, this study investigates the influence of essential newborn care education on newborn care practices among mothers in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding mothers' newborn care decisions through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, and environmental conditions in shaping maternal newborn-care behaviour. The Knowledge-Attitude-Practice framework provides a basis for examining how essential newborn care education may improve maternal knowledge and attitudes and influence newborn care practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how essential newborn care education may influence newborn care practices among mothers in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from mothers of newborns attending selected public and private healthcare facilities, postnatal clinics, immunization clinics, and community-based maternal and child health programmes in Nigeria using a structured interviewer-administered questionnaire and an essential newborn care practices assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible mothers. Where feasible, selected facilities or participant groups will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured essential newborn care education covering breastfeeding, thermal protection, hygienic cord care, newborn hygiene, infection prevention, immunization, postnatal care, recognition of newborn danger signs, safe newborn handling, and appropriate healthcare-seeking. Newborn care practices will be assessed using indicators such as early initiation and appropriate continuation of breastfeeding, thermal care, appropriate cord care, newborn hygiene, infection prevention, immunization practices, postnatal care attendance, recognition of danger signs, and timely healthcare-seeking when necessary. Where feasible, self-reported practices will be supplemented with direct observation, maternal and child health records, or other available facility documentation. Descriptive statistics will be used to summarize participants' sociodemographic and maternal characteristics, previous newborn-care education, knowledge, and newborn care practice scores. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple regression analysis, will be used to determine the influence of essential newborn care education on newborn care practices. Where appropriate, newborn care practices before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that essential newborn care education has a significant positive influence on newborn care practices among mothers in Nigeria. Mothers exposed to structured newborn care education are expected to demonstrate improved adherence to recommended practices relating to breastfeeding, thermal protection, hygienic cord care, newborn hygiene, infection prevention, immunization, postnatal care, danger-sign recognition, and appropriate healthcare-seeking. Education may increase mothers' confidence in caring for their newborns and reduce harmful practices resulting from misconceptions or inadequate information. Practical demonstrations and interactive education are expected to strengthen knowledge retention and improve mothers' ability to apply essential newborn care practices in the home environment. However, education alone may not guarantee appropriate newborn care because mothers may continue to experience financial constraints, limited access to healthcare services, cultural influences, inadequate family support, geographical barriers, and shortages of essential newborn-care resources. Consequently, essential newborn care education is expected to be most effective when supported by accessible postnatal services, community health support, trained healthcare professionals, appropriate newborn-care resources, and continuous maternal health education. The study is expected to contribute to the literature on essential newborn care, maternal health education, newborn health, breastfeeding, neonatal infection prevention, postnatal care, maternal and child health, health promotion, and public health in Nigeria by providing empirical evidence on the influence of essential newborn care education on newborn care practices among mothers. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, National Primary Health Care Development Agency, hospitals, primary healthcare centres, postnatal clinics, nurses, midwives, community health workers, maternal and newborn health programmes, development partners, and policymakers regarding strategies for improving home-based newborn care. The study will also provide evidence-based recommendations for strengthening essential newborn care education during antenatal and postnatal services, integrating practical newborn-care demonstrations into maternal health programmes, improving community-based newborn health education, strengthening postnatal follow-up, supporting breastfeeding and hygienic newborn care, improving access to newborn-care resources, and promoting evidence-based newborn care practices among mothers in Nigeria.

Keywords: Essential newborn care education, newborn care practices, mothers, Nigeria, newborn health, neonatal care, maternal health education, breastfeeding, thermal care, cord care, postnatal care, neonatal infection prevention, maternal and child health, health promotion, public health.