Caregiver Knowledge of Early Developmental Interventions After Perinatal Asphyxia at the Kenyatta National Hospital New Born Unit

Abstract

Long-term perinatal asphyxia has been associated with convulsive disorders, learning disabilities, neurodevelopmental delays, vision and hearing impairments among others. Despite this, the developing human brain has the potential to create new synaptic connections even after brain injury in what is known as neuroplasticity. Early developmental intervention (EDI) programs attempt to avert or curb compromised cognitive function in early life by the use of defined practices. These activities include sensory play, breastfeeding, early occupation therapy, music, tactile stimulation and reading. OBJECTIVE: The study aimed to assess the level of caregiver knowledge on early developmental interventions among babies with perinatal asphyxia at the Kenyatta National Hospital Newborn Unit. METHODOLOGY This was a descriptive cross-sectional study. Using a structured tool, 92 caregivers of babies admitted with perinatal asphyxia were interviewed to assess knowledge of early developmental interventions using closed and open-ended questions. Data was entered into excel and then imported into R software for cleaning and analysis. Categorical variables e.g., sex of babies and education level of caregivers was summarized in frequencies and proportions. Continuous variables e.g., caregivers’ age was summarized in means and standard deviations (normally distributed data) or medians and inter-quartile ranges for skewed data. A score for knowledge on neurodevelopmental interventions was computed based on five items. Each correct item was awarded one mark and then converted into a percentage score. The overall performance score was presented using a scatter plot diagram. RESULTS: The mean age of the caregivers who participated in this study was 29.4 years, 78.2% were married, and 68.5% were multigravida. The median age for babies was 2 weeks with an inter quartile range of one to three weeks of age and 75% were males. Overall only 8.9% of caregivers were informed that lack of oxygen just before or around the time of birth causes perinatal asphyxia, and 73% had no knowledge of the potential long-term impact of perinatal asphyxia. There was overall sufficient knowledge at 80% on early developmental interventions. Of those interviewed, 84.8% of caregivers identified play as a way of enhancing neurocognitive xiii development. A further 80.4% of caregivers had knowledge of ways to enhance their child’s speech and language, while 76% identified breastfeeding as a method of enhancing neuro cognitive development. The only factor associated with poor knowledge of neurocognitive development was being a primi-parous woman. Compared to multigravida women, the odds of having insufficient knowledge was OR 2.84 [(95% CI 1.11, 7.30), p =0.03] CONCLUSION There was overall sufficient knowledge of early developmental intervention activities at a median 80%. There was overall poor knowledge on the long-term outcomes of perinatal asphyxia where 73% of caregivers had no knowledge on the potential long-term outcomes of perinatal asphyxia. Multiparity was significantly associated with good knowledge (p=0.03)