Noninstitutional Births and Newborn Care Practices Among Adolescent Mothers in Bangladesh Mosiur Rahman, Syed Emdadul Haque, Sarwar Zahan, and Ohidul Islam Correspondence Mosiur Rahman, MSc, MHSc, Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi-6205, Bangladesh. swaponru_2000@yahoo.com Keywords newborn cord care thermal care breastfeeding postnatal care home birth ABSTRACT Objective: To describe home-based newborn care practices among adolescent mothers in Bangladesh and to identify sociodemographic, antenatal care (ANC), and delivery care factors associated with these practices. Design: The 2007 Bangladesh Demographic Health Survey, conducted from March 24 to August 11, 2007. Setting: Selected urban and rural areas of Bangladesh. Participants: A total of 580 adolescent women (aged 15–19 years) who had ever been married with noninstitutional births and having at least one child younger than 3 years of age. Methods: Outcomes included complete cord care, complete thermal protection, initiation of early breastfeeding, and postnatal care within 24 hours of birth. Descriptive statistics and multivariate logistic regression methods were em- ployed in analyzing the data. Results: Only 42.8% and 5.1% newborns received complete cord care and complete thermal protection. Only 44.6% of newborns were breastfed within 1 hour of birth. The proportion of the newborns that received postnatal care within 24 hours of birth was 9%, and of them 11% received care from medically trained providers (MTP). Higher level of maternal education and richest bands of wealth were associated with complete thermal care and postnatal care within 24 hours of birth but not with complete cord care and early breastfeeding. Use of sufficient ANC and assisted births by MTP were significantly associated with several of the newborn care practices. Conclusions: The association between newborn care practices of the adolescent mothers and sufficient ANC and skilled birth attendance suggest that expanding skilled birth attendance and providing ANC may be an effective strategy to promote essential and preventive newborn care. JOGNN, 40, 262-273; 2011. DOI: 10.1111/j.1552-6909.2011.01240.x Accepted January 2011 T he United Nations International Children’s Emergency Fund (UNICEF) reported that in 2009 the number of neonatal deaths globally con- stituted 37% all child deaths, resulting in about 3.7 million neonatal deaths per year (2009). A majority (98%) of these neonatal deaths occur in develop- ing countries where most newborns die at home under the care of mothers, relatives, and traditional birth attendants (Chandrashekhar et al., 2006; Saha & Kabir, 2009). Although Bangladesh is on track to achieve Millennium Development Goal 4 (MDG4), to reduce child mortality to approximately less than 50 per 1,000 live births by 2015 (Bangla- desh Progress Report, 2007), childhood mortality rates still remain very high. According to the Na- tional Institute for Population and Research and Training (NIPORT) in 2007 the mortality rate for those younger than 5 years of age was 65 per 1,000 live births, and neonatal deaths accounted for almost one half of all under-¢ve mortality. The high number of newborn deaths is a major concern, for the reduction of under-¢ve mortality and to achieve MDG 4. According to the most recent statistics released by the Bangladesh Bureau of Statistics (BBS) in 2003, adolescent men and women (aged 15^19 years) constitute one third of the total population of Ban- gladesh .This period is characterized by high risk for early and unwanted sexual activity, forced mar- riage, and pregnancy-related events (Rahman, 2009). Infants born to adolescent women face a sig- ni¢cantly higher risk of death compared to infants born to older women (Atuyambe et al., 2008). The Mosiur Rahman, MSc, MHSc, Department of Population Science and Human Resource Development, University of Rajshahi, Rajshahi, Bangladesh. Syed Emdadul Haque, MSc, MHSc, Department of Community and Global Health, The University of Tokyo, Tokyo, Japan. (Continued) The author reports no con- flict of interest or relevant financial relationships. JOGNN R ESEARCH 262 & 2011 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses http://jognn.awhonn.org