Neonatal hypothermia is a major contributor to neonatal mortality in sub-Saharan Africa, often as a comorbidity of severe infections, preterm births or asphyxia. Simple, cost-effective thermal care practices (TCPs) immediately at birth and in the post-natal period are recommended in the World Health Organization ‘warm chain’. Current practices are suboptimal in the home in low-resource settings, where approximately half of neonatal deaths occur. Several databases (PubMed, OVID SP, Web of Science, The Cochrane Library and Google Scholar) were searched for original research on home-based TCPs. Seventeen articles were identified, and the results were analysed using a ‘thermal care behavioural model’. This review of the qualitative literature on home-based practices across Africa illuminates the sociocultural factors affecting the uptake of recommended practices and strategies for behaviour change. Findings from the review confirm that potentially harmful cultural norms and traditions influence the sequence of TCPs in different contexts across Africa. Furthermore, caregiver factors and contextual barriers or facilitating factors to TCPs and behaviour change exist. Hypothermia and home-based TCPs are areas for further research. Thermal care behaviour change interventions tailored to the sociocultural context are necessary to improve neonatal outcomes in Africa.
AbbottDABerryMMeredithWH (1990) Religious belief and practice: a potential asset in helping families. Family relations39(4): 443–448.
2.
AberJLBennettNGConleyDC. (1997) The effects of poverty on child health and development. Annual Review of Public Health18(1): 463–483.
3.
AdejuyigbeEABeeMHAmareY. (2015) Why not bathe the baby today? A qualitative study of thermal care beliefs and practices in four African sites. BMC Pediatrics15(1): 1–7.
4.
AdejuyigbeEAOdebiyiAIAinaO. (2008) Feeding and care of low-birth weight babies in two rural communities in south-western Nigeria. Maternal and Child Nutrition4(1): 55–64.
5.
BangATBangRABaituleSB. (2005) Management of birth asphyxia in home deliveries in rural Gadchiroli: the effect of two types of birth attendants and of resuscitating with mouth-to-mouth, tube-mask or bag–mask. Journal of Perinatology25(1): 82–91.
6.
BrittenNCampbellRPopeC. (2002) Using meta ethnography to synthesise qualitative research: a worked example. Journal of Health Services Research & Policy7(4): 209–215.
7.
ByaruhangaRNNsungwa-SabiitiJKiguliJ. (2011) Hurdles and opportunities for newborn care in rural Uganda. Midwifery27(6): 775–780.
8.
CampbellRPoundPPopeC. (2003) Evaluating meta-ethnography: a synthesis of qualitative research on lay experiences of diabetes and diabetes care. Social Science & Medicine56(4): 671–684.
9.
CarrollCBoothALeavissJ. (2013) Best fit” framework synthesis: refining the method. BMC Medical Research Methodology13(1): 1–16.
DarmstadtGLKumarVYadavR. (2006) Introduction of community-based skin-to-skin care in rural Uttar Pradesh, India. Journal of Perinatology26(10): 597–604.
12.
DegefieTAmareYMulliganB (2014) Local understandings of care during delivery and postnatal period to inform home based package of newborn care interventions in rural Ethiopia: a qualitative study. BMC International Health And Human Rights14(1): 1–6.
13.
DhingraUGittelsohnJMoh’d SuleimanA. (2014) Delivery, immediate newborn and cord care practices in Pemba Tanzania: a qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices. BMC Pregnancy and Childbirth14(1): 2–11
14.
FikreeFFAliTSDurocherJM. (2005) Newborn care practices in low socioeconomic settlements of Karachi, Pakistan. Society of Science and Medicine60(5): 911–921.
15.
GathwalaGSinghBBalharaB (2008) KMC facilitates mother baby attachment in low birth weight infants. The Indian Journal of Pediatrics75(1): 43–47.
16.
GlennENChangGForceyLR (1994) Mothering: Ideology, Experience, and Agency. New York: Routledge.
17.
GondweAMunthaliACAshornP. (2014) Perceptions and experiences of community members on caring for preterm newborns in rural Mangochi, Malawi: A qualitative study. BMC Pregnancy and Childbirth14(399): 1–9.
18.
HillZTawiah-AgyemangCManuA. (2010) Keeping newborns warm: beliefs, practices and potential for behaviour change in rural Ghana. Tropical Medicine & International Health15(10): 1118–1124.
19.
KayomVOKakuruAKiguliS (2015) Newborn care practices among mother-infant dyads in Urban Uganda. International Journal of Pediatrics2015(815938): 1–8.
20.
KerberKJde Graft-JohnsonJE. (2007) Continuum of care for maternal, newborn, and child health: from slogan to service delivery. The Lancet370(9595): 1358–1369.
21.
KnippenbergRLawnJEDarmstadtGL. (2005) Systematic scaling up of neonatal care in countries. The Lancet365(9464): 1087–1098.
22.
KumarVKumarADarmstadtGL. (2010) Behavior change for newborn survival in resource-poor community settings: bridging the gap between evidence and impact. Global Perinatal Health34(6): 446–461.
23.
KumarVMohantySKumarA. (2008) Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trial. The Lancet372(9644): 1151–1162.
24.
KumarVShearerJCKumarA. (2009) Neonatal hypothermia in low resource settings: a review. Journal of Perinatology 29(6): 401–412.
25.
LunzeKYeboah-AntwiKMarshDR. (2014) Prevention and management of neonatal hypothermia in rural Zambia. PLoS One9(4): 1–7.
26.
LunzeKBloomDEJamisonDT. (2013) The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival. BMC Medicine11(1): 1–11.
27.
MbitiJ (2015) Introduction to African Religion. Long Grove: Waveland Press.
28.
MontanoDKasprzykD (2008) Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. Health Behavior: Theory, Research and Practice.
29.
NabiwembaELAtuyambeLCrielB. (2014) Recognition and home care of low birth weight neonates: a qualitative study of knowledge, beliefs and practices of mothers in Iganga-Mayuge Health and Demographic Surveillance Site, Uganda. BMC Public Health14(1): 1–11.
30.
OnaloR (2013) Neonatal hypothermia in sub-Saharan Africa: a review. Nigerian Journal of Clinical Practice16(2): 129–138.
31.
PejaverRKNisargaRGowdaB (2004) Temperature monitoring in newborns using thermospot. The Indian Journal of Pediatrics71(9): 795–796.
32.
RamanathanKPPaulVKDeorariAK. (2001) Kangaroo Mother Care in very low birth weight infants. The Indian Journal of Pediatrics68(11): 1019–1023.
33.
QuasemISloanNLChowdhuryA. (2003) Adaptation of kangaroo mother care for community-based application. Journal of Perinatology23(8): 646–651.
34.
SacksEMossWJWinchPJ. (2015) Skin, thermal and umbilical cord care practices for neonates in southern, rural Zambia: a qualitative study. BMC Pregnancy and Childbirth15(1): 1–11.
35.
SalasibewMMFilteauSMarchantT (2014) A qualitative study exploring newborn care behaviours after home births in rural Ethiopia: implications for adoption of essential interventions for saving newborn lives. BMC Pregnancy and Childbirth14(1): 1–7.
36.
SelepeHThomasD (2000) The beliefs and practices of traditional birth attendants in the Manxili area of KwaZulu, South Africa: a qualitative study. Journal of Transcultural Nursing11(2): 96–101.
37.
ShambaDSchellenbergJHildonZJ. (2014) Thermal care for newborn babies in rural southern Tanzania: a mixed-method study of barriers, facilitators and potential for behaviour change. BMC Pregnancy and Childbirth14(267): 1–9.
38.
SmithSNeupaneS (2011) Factors in health initiative success: learning from Nepal’s newborn survival initiative. Social Science & Medicine72(4): 568–575.
39.
ThairuLPeltoG (2008) Newborn care practices in Pemba Island (Tanzania) and their implications for newborn health and survival. Maternal and Child Nutrition4(3): 194–208.
40.
TuraGFantahunM (2015) Neonatal care practice and factors affecting in Southwest Ethiopia: a mixed methods study. BMC International Health and Human Rights15(18): 1–10.
41.
WaiswaPNyanziSNamusoko-KalungiS. (2010) I never thought that this baby would survive; I thought that it would die any time: Perceptions and care for preterm babies in eastern Uganda. Tropical Medicine and International Health15(10): 1140–1147.
42.
WaiswaPKemigisaMKiguliJ. (2008) Acceptability of evidence-based neonatal care practices in rural Uganda – implications for programming. BMC Pregnancy and Childbirth8(21): 1–9.
WinchPJAlamMAAktherA. (2005) Local understandings of vulnerability and protection during the neonatal period in Sylhet district, Bangladesh: a qualitative study. The Lancet366(9484): 478–485.
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
