Exploring Essential Newborn Care Practices and Predictors Among Non-Institutional Births in Urban Bangladesh

Abstract Background Non-institutional births, often occurring at home or in traditional settings, remain prevalent in Bangladesh despite ongoing efforts to promote facility-based deliveries. Ensuring essential newborn care (ENC) practices for these non-institutional births is crucial for reducing neonatal mortality and improving child health outcomes. This study aimed to identify current status and factors associated with the adoption of ENC practices among non-institutional births in urban areas of Bangladesh. Methods A secondary analysis of the 2165 mother-child dyads was conducted extracted from the 2019 Bangladesh Urban Health Facility Survey. Six ENC indicators as well as their composite index was considered as the outcome variables. Respondents’ socio-demographic factors were considered as the explanatory variables. Multivariate logistic regression model was used to explore association between outcome and explanatory variables. Results Approximately 37% of all mothers reported employing a minimum of three out of the six ENC practices. Among individual indicators, the highest adherence was observed for the use of a sterilized instrument to sever the umbilical cord (90%), while the lowest adherence was noted for delayed bathing (7.4%). The likelihood of adopting at least three of the six ENC indicators was lower among mothers in relatively higher wealth quintiles, while it was higher among those residing in non-slum areas of city corporations and in the divisions of Chattogram, Khulna, and Sylhet. Concerning individual indicators, factors associated with each ENC practice varied, with no specific indicator consistently significant across all categories. Conclusion More than two-thirds of all mothers do not report employing a minimum of three ENC practices in urban areas of Bangladesh. This lower adherence to ENC practices may be linked to elevated neonatal and under-five mortality rates in Bangladesh. There is a crucial need for awareness-building programs to educate the population about the significance of practicing ENC for improving child health outcomes.