Assessment of knowledge on causes and care of neonatal jaundice at the Nigerian primary and secondary health institutions

Abstract

Background: Neonatal jaundice is the most common condition that requires medical attention in new-borns. However, missed diagnosis of jaundice, poor monitoring, and prescriptions of wrong and ineffective medications by the health workers for jaundice are known to be responsible for the persistence of acute bilirubin encephalopathy in the sub region. Therefore, the aim of the present study was therefore to assess the knowledge in the care of neonatal jaundice at the primary and secondary health care delivery in Nigeria so as to improve it. Methods: A cross-sectional study conducted at 12 local government primary health and maternity centers and 2 state owned general hospitals (secondary health facilities) in Osun State, Southwest Nigeria between January and June 2014. Consent was obtained from the health workers at the health facilities. A structured questionnaire was administered to all the staffs on duty and during the shifts of duty. The questionnaire contained questions to assess the knowledge of the health workers with regard to neonatal jaundice causes, treatment and complications. Staff judgment on the effectiveness of methods and drugs being prescribed were also assessed. Results: One hundred and forty one (67.5 percent) were primary health care workers and 68 (32.5percent) were staff in secondary health care facilities. There was significantly better understanding of causes, management and complications of neonatal jaundice among secondary health care workers than primary health care workers (p at least 0.007). Common pharmacological agents prescribed were Ampiclox (Ampicillin-Claxacillin formulation), Glucose water, Multivitamins, phenobarbitone, other antibiotics and injections at both health care levels. Conclusions: There is therefore urgent need to train health workers of all cadres on causes, care, effective treatment and complications of neonatal jaundice to reduce the high prevalence of bilirubin encephalopathy. Facilities like effective phototherapy units should be made available at health facilities and training centres.