Personal interactions with frontline health workers revealed that, sepsis is one of the 4 top disease condition for neonatal mortality in some hospitals in the Ghana. Neonatal mortalities or newborn mortalities are deaths of babies within the age 0 – 28 days. The most important underlying condition for neonatal sepsis and its adverse event among neonates in the region is umbilical cord sepsis. Omphalitis, infection of the umbilical cord stump, is also another type of infection that can easily progress to sepsis and it is a life threatening disease for neonate.
Umbilical cord sepsis is primarily caused by the transmission of infectious diseases. Commonly known subtypes of this disease include contagious (i.e. it easily spread between persons and/or from the surroundings). Example, when aseptic conditions are not adhered to in clamping, cutting or dressing the cord, infection is likely to occur. The other subtype is infectious (transmission by a pathogenic organism like virus, bacteria, fungi etc). Umbilical cord infection can be transmitted by saliva, cough, blood, air and from mother to fetus, among others. The disease is not genetic or defect of a gene.
Early rapture of the membrane can cause mother to fetus transmission. The instruments used in cutting the cord can cause infection if not properly sterilized. The substances used in dressing or treating the cord can also cause infection. The application of substance like concoctions, cow dung, heated stone, saliva, clay, toothpaste, gentian violet solution among others on the baby’s cord are some common ongoing practices that account for cord sepsis among neonates.
These practices are more prevalent at the community level. However, some health workers are reported to be engaged in the application of toothpaste on babies cord. My concern is, if this is true, why will professionals do such a thing? Who is monitoring what is going on? Can it be said that, some of these practices are due to the health worker’s own personal belief. How will they educate women on how to properly manage babies cord? Are there guidelines recommending the accepted substance for dressing cord, has the issue to do with the non availability or stock out of the appropriate substances (system failure)?
The many interventions geared at assisting and accelerating Ghana achieve its MDG 4 have not been able to show promising results due to the low persistent increase in neonatal mortalities in the country. To save the newborns, and to help Ghana achieve its goal, we all have a role to play.
I will be sharing in another post tips on proper umbilical cord care, but below is an info-graph on basic things you should and should not do in umbilical cord care.