This study, conducted by the Provincial Health Development Centre (PHDC) Sindh, adapted the UNICEF/WHO designed questionnaire for collecting data on Eight Key Family Practices, pertaining to appropriate antenatal care, exclusive breastfeeding, immunization of mother and neonate, homecare for illness including continuous breastfeeding during illness, home treatment of infections, health care seeking, and compliance for prescribed treatment, and adequate hygienic and sanitary practices.
The data was collected in the Malir, Hyderabad, Tando Allahyar, Naushahro Feroze and Jacobabad districts in the province of Sindh that included from mothers of neonates of 28 or less days. Some 813 mothers participated in the study.
Conclusions and Recommendations
1. Several healthy practices have been reported by the study population, including: use of fluids during illness, particularly in diarrhoea; hand washing after using toilet and assisting a child in defecation; exclusive breast feeding; and utilization of Skilled Birth Attendants for deliveries etc. These positive practices require re-enforcing by the health care providers during lane sessions, health education meetings and individual interactions, and also by National MNCH Programme through print and electronic media.
There are behaviours and practices among health care providers, mothers and family members which need to be modified including: unnecessary use of iron and blood infusions for treating anaemia instead of promoting healthy dietary habits; gratuitous C-section practices; the restriction of nutritious food during pregnancy; and the late decision of mothers and family members to seek outside treatment for the neonate if needed. It is recommended that specific protocol having standard classification system, particularly for appropriate mode of delivery and rationale use of drugs and infusions should be developed and institutionalized.
Female autonomy in decision making for seeking the health care for herself and her neonate has also emerged strongly in this study. This might have resulted due to overall socioeconomic development and cultural change. This positive development needs further promotion and re-enforcement through BCC/IEC campaigns in order to ensure timely provision of health care if a prompt decision is required for outside treatment in case of an emergency.
The study has generated important information which should be owned and capitalized by Maternal, New-born and Child Health Programme, National Programme on Family Planning and PHC, and the Provincial and Regional ministries of health. The challenge, however, lies in re-establishing the culture of promoting key family practices focused in this study.
Anon. Baseline survey of eight key family practices in Sindh. June 2010-June 2011. Provincial Health Development Centre Sindh, Jamshoro, Pakistan (2012) 118 pp.