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Cultural/financial causes of neonatal hypothermia
- C. Anthony Ryan (18 August 2005)
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C. Anthony Ryan, Consultant Neonatologist Department of Paediatrics and Child Health, Cork University Hospitals, Wilton, Cork, Ireland
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During a recent visit to Sudan, I was also struck by the high incidence neonatal hypothermia, described by Byaruhanga et al, in Uganda. Some reasons for hypothermia, (which has been shown to be an independent risk factor for death in neonates) in Suadan, appeared obvious. These included air conditioning to temperatures that were cool for lightly clothed adults. A lack of appropriate towels and other laundry items also was apparent. However, the main reason for neonatal hypothermia subsequently emerged later in our visit. Midwives in Sudan are not that well paid. They are dependent on tips from the mothers to supplement their meagre salaries. The birthing tip, equivalent to approximately 5 euros, is given to the midwife when she presents the baby to the mother. Immediately after birth, however, babies are left to lie naked in open cots, while the busy midwife completes the the third stage of labour. Later the baby is washed and clothed and is then presented to the mother. Thus, neonatal hypothermia due to the lack of body contact with the mother, can be due financial incentives. The practice of delaying body contact may be difficult to alter by education alone, unless the underlying issue of midwives' remuneration is also addressed. Conflict of Interest:None declared |
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