Pattern, determinants and risk analysis of care seeking for preterm newborns: A study in rural Bangladesh

Background: More than a quarter of early neonatal mortality in developing countries is attributable to lack of perinatal care seeking. A better understanding of the barriers and challenges to appropriate care-seeking is critical to enhance care-seeking for neonates, particularly for preterm babies who are at higher risks of morbidity and mortality. Method: Prospective data from 30,944 live births, including 6,378 preterm babies, were collected during June 2007 -September 2009. Log binomial regression and multinomial logistic regression model were employed for data analysis. Results: Almost one-fifth (19.8%) preterm newborns sought care from outside home (6.2% from qualified providers and 13.6% from non-qualified providers), while preterm newborns without care seeking were found higher in proportion compared to babies born at term (80.2% vs. 78.7%). Homeopath practitioners were found as the most preferred health care provider (50.0%). Compared to males, female preterm babies were 8% more likely to be at risk for not seeking care (RR: 1.08; [1.05, 1.10]). Birth preparedness (RRR: 1.39 [1.09 – 1.78]) and any ANC visit (RRR: 1.93 [1.50 – 2.49]) increased the likelihood of seeking care from qualified care for preterm born babies. Conclusion: These study findings proposed following programmatic measures to reduce health risks among preterm babies by enhancing care seeking for those in needs: 1) Community level awareness raising campaign on health risks for preterm neonates; 2) Involve non-formal and non-qualified health providers into health education and counselling sessions in the community; 3) Antenatal counselling of pregnant women and families about postnatal care seeking practices.