EVALUATING MATERNAL UNDERSTANDING OF WHO-RECOGNIZED NEONATAL DANGER SIGNS: A CROSS-SECTIONAL STUDY

Abstract

Background: Neonatal mortality constitutes a significant proportion of under-five mortality worldwide, with over 2.4 million neonatal deaths reported annually. In Pakistan, the neonatal mortality rate (NMR) stands alarmingly high at 42 per 1,000 live births. Neonatal danger signs, such as fever, jaundice, and breathing difficulties, require immediate medical attention but often go unrecognized due to insufficient maternal knowledge. Socioeconomic disparities, cultural practices, and inadequate access to healthcare exacerbate the issue, delaying timely interventions and contributing to preventable neonatal deaths.

Objective: The study aims to assess maternal knowledge of neonatal danger signs, identify determinants of adequate awareness, and explore barriers to timely healthcare-seeking practices.

Method: A cross-sectional, community-based survey was conducted from August to December 2024 in one urban and one rural district of Sindh, targeting mothers of neonates aged 0–28 days. A structured questionnaire adapted from the WHO Safe Motherhood Toolkit was used to collect data on maternal knowledge, antenatal care (ANC) attendance, and healthcare-seeking behaviors. A multistage random sampling method ensured representativeness, with a sample size of 300 participants. Descriptive statistics and logistic regression analyses were performed using SPSS version 25 to identify key predictors of knowledge, with significance set at p<0.05.

Results: Among 300 mothers, 48.5% demonstrated adequate knowledge of neonatal danger signs. Fever (75%), poor feeding (62%), and jaundice (51%) were the most recognized signs, while hypothermia (18%) and convulsions (12%) were least identified. Maternal education, urban residence, and ANC attendance significantly predicted knowledge levels. Only 57% sought timely medical care, with rural participants reporting financial constraints, transportation challenges, and reliance on traditional healers as primary barriers.

Conclusion: Maternal knowledge of neonatal danger signs remains suboptimal, especially in rural areas. Targeted health education programs, improved healthcare access, and financial support mechanisms are essential to enhance neonatal survival and reduce preventable deaths.