Healthcare professionals are promoting a new method of umbilical cord care by using chlorhexidine jelly on newborns in an effort to cut infant mortality rates in western Kenya.
Communities in and around the region have used traditional ways of umbilical cord care on babies, including applying ash, cow dung, lizard droppings, mud and even kitchen soot on the cord.
Some tie a piece of cloth to the cord. However, this traditional method delays healing.
Applying chlorhexidine jelly, an antiseptic, protects newborn babies from sepsis and other infections which are a major cause of newborn deaths within the first two weeks.
During pregnancy, the umbilical cord supplies nutrients and oxygen to the developing baby.
After birth, the umbilical cord is no longer needed so it is clamped and snipped. This leaves behind a short stump. The baby's umbilical cord stump then dries out and eventually falls off.
“For my first six children, I used to apply soot on the umbilical cord. I did so because that is what my grandmother showed me,” said Beatrice Akuku, a mother of seven.
“When it is applied, it could take two weeks to heal and that’s a long time,” she added.
She noted the healing time difference between the soot and the chlorhexidine jelly on her seventh child—the jelly dried the umbilical cord within a week.
Jackline Cherotich, a mother of four children, said she was taught by her grandmother to tie a cloth or put soft mud on the umbilical cord.
“I started using the modern method for my third born after delivering at Nangina dispensary which took only one week for the cord to recover,” said Cherotich.
Data from Kenya Demographic Health Survey (KDHS) shows that, at least one in every 45 children born in Kenya dies before reaching their fifth birthday. The level of under-five mortality is 22 deaths per 1,000 births.
Hospitals are far away
Located near the border of Kenya and Uganda, Bunandi village in Busia County is trying to educate mothers on how to take care of their newborn’s umbilical cord.
“My colleagues were using soot, cow dung but few of us realized children could develop problems, so we stopped but continued using salty water for a long time,” said Magrate Nabwire, one of the few remaining midwives in Bulandi.
“Nowadays things are normal, as hospitals are around. During our times there were no hospitals, we could walk hundreds of kilometers to Busia or Kisumu towns for someone to get medical services because there were no vehicles,” Nabwire recalls.
Villagers complain that lack of hospitals is the primary reason many women still continue embracing traditional ways of treating a healing umbilical cord in western Kenya.
However, with the help of community health workers, residents in this area are now receiving cord care and other medical services in their homes.
Roselyne Makokha, a Bunandi community health volunteer, has been training women on how to use chlorhexidine jelly on their newborn babies at home. She blames culture among the residents and religious beliefs for traditional practices.
"Previously women used traditional medicines to heal the umbilical cord because culture and religion was forbidding them, but now the world has changed. I appeal to women to deliver at the hospital. Those days of delivering at home are gone,’’ said Makokha.
At Teso north hospital, Tezra Okal, the head nurse in the maternity wing, is a firm believer in the antiseptic jelly.
“Immediately after the baby is born, we apply chlorhexidine jelly in the delivery room, from the root of the cord. It is applied once in a day until the cord drops or for at least seven days,” Okal explains.
The nursing staff show new mothers how to apply the jelly to their babies’ umbilical cord.
In spite of the traditions in this region, Okal says many residents are implementing the new method.
“We have had many cases of neonatal sepsis through the umbilical cord. When chlorhexidine was introduced it has shown that it has reduced umbilical infection by around 68 percent,” said David Githinji, who is a medical project officer at Save the Children organization.
The group, working in partnership with the government of Kenya, says 30,000 children have benefited from this treatment in western Kenya, and plans are underway to roll out the program countrywide within the next five years.
In addition to Kenya, countries such as like Uganda, Tanzania, Burundi, Rwanda have also started embracing this new method of umbilical cord care for new born babies to curb neonatal sepsis cases on the continent.