Hand Washing and Other Hygienic Cord Care Practices among Mothers in Nnewi, Nigeria

Background:  Neonatal sepsis is a major contributor to the high burden of neonatal deaths in sub-Saharan African countries like Nigeria. Hygienic cord care has the potential to reduce neonatal mortality from infections. Aim: We examined the rate of hand washing and other hygienic cord care practices among mothers in Nnewi Nigeria. Methods: A cross-sectional study was conducted among 214 consenting mothers who had a biologic child less than one year of age. Mothers were interviewed using semi-structured interviewer-administered questionnaire. The major outcome variables were practice of hand washing and other indicators of hygienic cord care such as frequency of cord care, cord care after diaper change, re-use of swabs and method of cord care. Data was analyzed using SPSS version 21. P-value < 0.05 was considered statistically significant. Results: The mean age of the mothers was 29.6 ± 5.53 years. The rate of hand washing before, after, both before and after, and neither before nor after cord care were 81.3%, 76.2%, 68.7% and 11.2%, respectively. Majority of the mothers practiced cord care activities for ≥3 times (79.9%), did not re-use swabs for cleaning the cord (92.5%) and used methylated spirit for cord care (89.3%). However, only one mother (0.5%) used chlorhexidine gel for cord care while half did not practice cord care after diaper change. Factors significantly associated with practice of hand washing before and after cord care were access to health education during pregnancy, knowledge of the consequence of poor cord care, and use of antiseptic agent for cord care. The respondents had a fairly good practice of hygienic cord care. However, many babies still faced the risk of sepsis due to failure of their mothers to practice hand washing both before and after cord care, and after diaper change as recommended. Intensive promotion of hygienic cord care recommendations is endorsed.