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Traditional Beliefs and Practices in New Born Care at Different Communities-

Literature Review

Article  in  International Journal of Nursing Care · January 2017

DOI: 10.5958/2320-8651.2017.00017.5

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 DOI Number: 10.5958/2320-8651.2017.00017.5

Traditional Beliefs and Practices in New Born Care at

Different Communities - Literature Review

Anil Sharma1, Arpan Pandya2

1
Associate Professor, Manikaka Topawala Institute of Nursing-CHARUSAT, Changa, Gujarat, 2Assistant Professor,
Manikaka Topawala Institute of Nursing –a constituent of Charotar University of Science & Technology, Changa,
Ta: Petlad, Dist.- Anand, Gujarat, India

ABSTRACT

The current study aims to understand the neonatal care practices among various communities the researcher
has done a extensive literature review to understand in depth concepts and ideas of peoples of different
communities. Health team members should be aware of traditional behaviors which may pose health risks
and attempt to change these behaviors

It was concluded that there are unscientific and superstitious practices are following by family members,
which are prevailing as the name of traditional practice.

Keyword: Traditional belief, neonatal care, newborn care practices, umbilical cord practices.

INTRODUCTION In the effort to understand the neonatal care

Great efforts have been made to improve the health
of children around the world over the past four decades,
with some notable successes. Yet, achievements have not
been as expected and child mortality rates are still high.
Globally, it is estimated that 10 million children under
five years die in a year, out of which four million deaths
occur in the first 28 days alone. Two-thirds of newborn
deaths are due to infections, pre-maturity and asphyxia,
which are preventable. Out of these deaths, 99% occur in
the lower and middle income countries.1
One of the eight Millennium Development Goals
(MDG) drawn up and accepted by the international
community in 2000, as a means of achieving social
and economic progress in all countries, is a reduction
in under five mortality rates by two-thirds by the year
2015. To meet this goal all countries, particularly
sub-Saharan African and South East Asia where child
mortality rates, especially newborn mortality rates, are
high, need to make more effort.2
Corresponding author:
Dr. Anil Sharma
Associate Professor, Manikaka Topawala Institute
of Nursing –a constituent of Charotar University of
Science & Technology, Changa, Ta: Petlad, Dist.-
Anand, Gujarat-388421. India
practices among various communities the researcher has
done a extensive literature review to understand in depth
concepts and ideas of peoples of different communities.
The literature reviewed was obtained through
different database which includes Cochrane, CINHAL
(Cumulative Index to Nursing & Allied Health
Literature), MEDLINE (Medical Literature Analysis
& Retrieval System Online), PubMed, Science Direct,
Springer Link, ProQuest & Google scholar.
MATERIAL, METHOD AND FINDINGS
Literature review worked as Methodology.
A descriptive study was conducted at Nitte
Usha Institute of Nursing Sciences, Nitte University,
Deralakatte, Mangalore by Reshma and Sujata on cultural
practices and beliefs on newborn care among mothers.
157 samples were selected by using purposive sampling
by using dichotomous questionnaire. The study results
obtained by using descriptive statistics reviled that 149
(95%) of the mothers have followed oil massage for the
baby before bath. 83 (53%) of the mothers have provided
home remedies for the baby. 87 (55%) of the mothers
were applying ashes, soot, powder, or dry cow dung,
115 (73%) mothers exposed their babies to the sunlight
when the baby’s skin turns yellowish. 129 (82%) of the
 81 International Journal of Nursing Care, January-June 2017, Vol. 5, No. 1
mothers are applied ‘Kajal’ on baby’s face to prevent
bad eye. 92 (59%) of the mothers are practicing a belief
that “empty cradle should not be moved”. Findings of
the study revealed that there is a strong relationship
between the demographic variables (type of family and
religion) and cultural practices and beliefs on newborn
care among mothers.3
A descriptive study was conducted at Turkey by
Ayşe Beşer, Sevcan Topçu, Ayşegül Çoşkun at.el on
“Traditional Child Care Practices Among Mothers
With Infants Less Than 1 Year Old” with objective of
to determine traditional child care practices of women
with infant less than one year’s age. The descriptive
survey design was adopted for study and setting was
four districts of Izmir, where health care is offered by
the Primary Health Center. Data were collected by face
to face with a questionnaire prepared by the researchers
in view of the relevant literature. The study sample
included 70 mothers with infant less than one year old
babies. The study results revile that Turkish mothers
had traditional child care practices pertinent to bathing
and cutting nails of babies for the first time, swaddling,
removal of the umbilical cord, the evil eye and “kýrk
basmasý”. The study results concluded that some of
these traditional health behaviors can cause health
risks. Therefore, nurses should be aware of traditional
behaviors which may pose health risks and attempt to
change these behaviors.4
A case study was conducted on “new born care
practices” among tribal women’s of Bhil Trible
population of Bharuch District of Gujarat by Bajju
Dinesh Shah and Laxmi Kant Dwiwedi to identify
the newborn care practices and beliefs, analyze their
harmful or beneficial characteristics, describe the
deviations from the essential newborn care practices
during hospital/home delivery, explain barriers to care
seeking and identify areas of potential resistance for
behavior change; and utilize study findings to tailor-
make cost-effective essential newborn care package.
The study uses qualitative data from in-depth interview
of mothers who had experienced neonatal death and
key-informant interviews with healthcare personnel
and birth attendants. Key finding of this study is less
prevalent practice of essential newborn care among all
cases irrespective of place of delivery and the health-
care personnel facilitating delivery. Habitual traditional/
tribal newborn care methods challenge the practice of
prescribed essential newborn care. Clustering of deaths
in few households added significantly to the existing
burden of neonatal deaths, attributed to superstition
“Ratewa” by tribal. Study has concluded that the
introduction and implementation of essential newborn
care at hospital and community/ household level are the
need of the hour.5
A cross-sectional survey study was conducted on
“Newborn care practices and home-based postnatal
newborn care program” at Mewat Haryana by Sinha
LN, Kaur P, Gupta R et. al. among mothers who
had delivered a child during the seven months using
cluster sampling. Researchers interviewed mothers and
ASHAs in the selected subcenters using semi-structured
questionnaires on the six safe newborn care practices,
namely safe breastfeeding, keeping cord and eyes clean,
wrapping baby, kangaroo care, delayed bathing and
hand washing. The researcher interviewed 320 mothers,
61 ASHAs and observed 19 home visits. Overall, 60% of
mothers adopted less than three safe practices. Wrapping
newborns (96%) and delayed bathing (64%) were better
adopted than cord care (49%), safe breastfeeding
(48%), hand washing (30%), kangaroo care (20%) and
eye care (9%). Cultural beliefs and traditional birth
attendants influenced the mother’s practices. The lack
of supervision by auxiliary nurse midwives, delayed
referral and transportation were the other challenges.
The study results concluded that Knowledge-practice
gaps existed among mothers counselled by ASHAs.
Poor utilization of reproductive and child health
services decreased opportunities for ASHA-mother
dialogue on safe practices. Recommendations included
training ANMs, training TBAs as ASHAs, innovative
communication strategies for ASHAs and improved
referral system.6
A formative research study was conducted at
Rural Bangladesh by Hunter EC, Callaghan Koru et.
al. to explore existing newborn care practices in rural
Bangladesh with an emphasis on thermal protection,
and to identify potential facilitators, barriers, and
recommendations for the community level delivery of
kangaroo mother care. Forty in-depth interviews and 14
focus group discussions were conducted. Participants
included pregnant women and mothers, husbands,
maternal and paternal grandmothers, traditional birth
attendants, village doctors, traditional healers, pharmacy
men, religious leaders, community leaders, and formal
healthcare providers. Researchers find that harmful
newborn care practices, such as delayed wrapping
 International Journal of Nursing Care, January-June 2017, Vol. 5, No. 1
and early initiation of bathing, are changing as more
biomedical advice from formal healthcare providers is
reaching the community through word-of-mouth and
television campaigns. findings showed that participants
appreciated CKMC as an appropriate treatment method
for ill babies, but were less accepting of it as a protective
method of caring for seemingly healthy newborns
during the first few days of life. Participants highlighted
the necessity of receiving help from family members
and witnessing other women performing CKMC with
positive outcomes if they are to adopt the behavior
themselves. Focusing intervention messages on building
a supportive environment for CKMC practice will be
critical for the intervention’s success.7
A prospective, cross-sectional, population-based,
descriptive study was conducted by Le LT1, Partridge JC,
Tran BH et. al. at The National Hospital of Pediatrics in
Vietnam to “assess care practices and traditional beliefs
related to neonatal jaundice.” Researchers prospectively
identified mothers of newborns through an on-going
regional cohort study. Trained research assistants
administered a 78-item questionnaire to mothers during
home visits 14-28 days after birth except those we could
not contact or whose babies remained hospitalized at 28
days. This study reveals that out of 979 mothers 99%
delivered at a health facility. Infants were discharged at
a median age of 1.35 days. Only 11% received jaundice
education; only 27% thought jaundice could be harmful.
During the first week, 77% of newborns were kept in
dark rooms. Only 2.5% had routine follow-up before
14 days. Among 118 mothers who were worried by
their infant’s jaundice but did not seek care, 40% held
non-medical beliefs about its cause or used traditiona
l therapies instead of seeking care. Phototherapy was
uncommon: 6 (0.6%) were treated before discharge
and 3 (0.3%) on readmission. However, there were no
exchange transfusions, kernicterus cases, or deaths. The
study concluded that early discharge without follow-up,
low maternal knowledge, cultural practices, and use
of traditional treatments may limit or delay detection
or care-seeking for jaundice.8
A cross-sectional study was conducted in tribal
block in Nabarangpur district of Odisha, India, by
Pati S, Chauhan AS, Panda M on “Neonatal care
practices in a tribal community of Odisha, India: a
cultural perspective” to measure perinatal and antenatal
practices by qualitative inquiries of 55 mothers who
had babies aged <60 days and from 11 traditional birth
82
attendants. Reasons for home deliveries were cited
as easy availability of traditional birth attendants and
family preferences. Application of indigenously made
substances on umbilical stump and skin of the baby,
bathing baby immediately after birth, late initiation
of breast-feeding and ‘Budu practices’ were common.
Cultural issues, decision of family members and
traditional beliefs still play a crucial role in shaping
neonatal care practice in tribal communities. Awareness
on child care, ethnographic understanding of health-
seeking behaviour of tribal community and mobilization
of community by health workers can be useful in
improving health status of mothers and new born babies
in tribal population.9
A cross-sectional descriptive study was conducted
to detect traditional methods applied for the treatment
of newborn jaundice by mothers in Turkey. 229
mothers with newborn babies aged 0-28 days in one
university hospital and one public children’s hospital in
Sanliurfa were evaluated by knowledge questionnaires
on the beliefs and traditional methods of mothers for
jaundice and data was analyzed by descriptive and
inferential statistics. This study reveals Mothers apply
conventional practices in cases of health problems
such as jaundice and application of these methods is
important to mothers. Moreover, mothers reported
applying hazardous conventional methods in cases of
neonatal jaundice, such as cutting the area between the
baby’s eyebrows with a blade etc. are not applied in
different cultures. It concluded that education regarding
the effects of conventional methods being applied in
families should be provided, and the results of this study
should serve to guide further studies in assessing the
effects of such education.10
A study was conducted at rural Haryana by
Upadhyay RP, Singh B, Rai SK, Anand K to study the
role of prevalent culturally driven beliefs and practices
in influencing home-based newborn care in 28 villages
under Comprehensive Rural Health Services Project, All
India Institute of Medical Sciences. Total 415 mothers
who had a baby in the second month of life, at the time
of the visit for data collection were interviewed using
pre-tested questionnaire. This study reveals nearly 77%
of mothers reported some beliefs/practices to care of
the cord. 81.0% mothers had beliefs regarding taking
the baby out of the house for the first time after
birth. 11% did not prefer their baby to be weighed at
frequent intervals as they believe; doing so could lead
 83 International Journal of Nursing Care, January-June 2017, Vol. 5, No. 1
to slowing of the growth of the baby. It concluded that
traditional knowledge and practices must be considered
before developing neonatal health care intervention
strategies.11
A naturalistic qualitative descriptive study was
conducted on perinatal beliefs and practices among
Punjabi women living in Canada by Grewal SK,
Bhagat R, Balneaves LG at Canada. Fifteen first-time
mothers who had immigrated in the past 5 years to
Canada from Punjab, India, and had given birth to a
healthy infant in the past 3 months in a large urban
center in British Columbia, Canada. Five health
professionals and community leaders also took part
in a focus group to confirm the study findings and to
offer recommendations. The study results shown that
three major categories emerged: the pervasiveness
of traditional health beliefs and practices related to the
perinatal period, the important role of family members in
supporting women during the perinatal experiences, and
the positive and negative interactions women had with
health professionals in the Canadian health care system.
The study concluded that Change is required at the
levels of the health professional, the heath care system,
and the community to ensure that culturally safe care is
provided to immigrant Punjabi women and their families
during the perinatal period, which is an important and
sensitive period of interaction with the Canadian
health care system.12
CONCLUSION
The present paper is a part of minor research project.
The project aimed to know prevalence of Traditional
beliefs and practices in new born care at different
communities. It was concluded with this literature review
that the prevalence of such unscientific and superstitious
newborn practices with the name of traditional beliefs
are very high and. Health team members should be
aware of traditional behaviors which may pose health
risks and attempt to change these behaviors.
Acknowledgement: We would like to acknowledge
CHARUSAT University, Changa, Gujarat, India.
Conflict of Interest: None
Source of Funding: No funding received for this
project
Ethical Clearance: The study approved by
CHARUSAT.
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 International Journal of Nursing Care, January-June 2017, Vol. 5, No. 1 84

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