Level of Knowledge of Neonatal Danger Signs and Factors That Influence Knowledge Among Mothers at Juba Teaching Hospital and Al Sabbah Children’s Hospital in Juba, South Sudan – a Hospital-based Descriptive Cross Sectional Study

Abstract

Background: The Neonatal Mortality Rate (NMR) in South Sudan is high at 38.6 deaths per 1000 live births. Early detection and timely care seeking for sick neonates are critical steps in improving neonatal survival. Poor knowledge of neonatal danger signs (NDSs) results in poor care seeking practices. This study aimed to determine the level of knowledge of NDSs among mothers in Juba and their care seeking practices once illness is recognized. Objectives: The primary objective was to assess the level of knowledge of NDSs among mothers at two public health facilities in Juba, South Sudan. The secondary objectives were to assesses care seeking practices of mothers of sick neonates and to determine the factors that influence this knowledge and care seeking practices. Method: A hospital based descriptive cross-sectional study of mothers of neonates seeking services at JTH and Al Sabbah Children’s Hospital. An interviewer administered questionnaire was used to capture sociodemographic data as well as knowledge of NDS and care seeking practice. Knowledge on NDSs and care seeking practice was presented as percentages with 95% confidence intervals (CI). Logistic regression models were used to find associations between variables, with statistical significance set at p<0.05, Results: A total of 274 mothers were recruited. Only 36%(95%CI:30.1%–41.8%), were found to have good knowledge on NDS. Internet access AOR =2.77, 95%CI:1.34–5.73, p =0.006, prior knowledge on NDS AOR =2.93, 95%CI:1.58–5.45, p =0.001 and NBU admission OR =4.00, 95%CI:1.4–10.90, p =0.009 were factors associated with good knowledge. Only 55% of mothers of sick neonates sought medical care withing 24 hours. Factors associated with good care seeking practice included neonatal age ≤7 days OR =2.01, 95%CI:1.12–3.83, p =0.022, and maternal possession of a smart phone, OR =1.90, 95%CI:1.10–3.61, p =0.035. Conclusion: Maternal knowledge on NDSs and care seeking practice for neonatal illness were poor. Effective education programs on NDSs and appropriate health seeking practise for neonatal illness are needed