Fouzia Ishaq, Syeda Sabeeka Batool, Hasnain Abid, Zahida Sarwar, Jovaria Mannan.
Situational Analysis of Existing Practices and Protocols for Umbilical Cord Care & Use of Chlorhexidine.
Pak Paed J Jan ;39(4):209-16.

Objective: To explore the existing practices and protocols for cord care among healthcare providers at various levels (e.g. community/home based deliveries as well as primary and secondary health facilities both public and private) and to organize recommendations from key stake holders e.g. technical experts, policy makers and implementers about the use of chlorhexidine for cord care. Study Design: Cross sectional study Place & duration of Study: The study was carried out in five districts (Lahore, Karachi, Quetta, Muzaffarabad and Gilgit) of five provinces/regions of Pakistan (Punjab, Sindh, Balochistan, Azad Jammu Kashmir and Gilgit-Baltistan) respectively from April-June, 2014. Subject and Methods: A total of 153 participants from various disciplines including policy makers to first level health care providers were included in this study. Different semi-structured questionnaires were designed for policy makers/implementers and health care providers from primary to tertiary care level. Both qualitative and quantitative types of data were collected and the quantitative data analyzed through Microsoft Excel software. The results were expressed in percentages and presented in the form of tables. Results: Half of the policy makers (50%) and Program Managers (56%) while 22% technical experts knew about WHO guidelines for Newborn care; 78% of technical experts were unaware of any national, provincial or WHO guidelines. All had knowledge about Chlorhexidine as an antiseptic for cord care. Spirit was found to be commonest antiseptic used for umbilical cord care in public and private health facilities as well as community settings. Private Health care providers, community midwife and lady health worker had never heard about chlorhexidine use for cord care. Conclusion: There is vast knowledge gap among various health care cadres i.e. policy/decision maker to primary level healthcare provider about WHO guidelines and chlorhexidine use for umbilical cord care. Methylated spirit is still the most commonly applied antiseptic for umbilical cord care.

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