2018 P A W  P A NAPNAP 2018 NATIONAL CONFERENCE POSTER AWARD WINNERS AND PRESENTATION ABSTRACTS Success of a Community Campaign in Haiti: Newborn Umbilical Cord Care Susan Walsh, DNP, C-PNP, Linda McCreary, RN, PhD, Kathleen Norr, PhD, & Heather Sipsma, PhD Category/Date: Research Poster presented at Posters on The Move, at NAPNAP’s 39th National Conference on Pediatric Health Care, March 19, 2018, Chicago, IL. Purpose: Develop a community campaign to reduce neonatal sepsis due to umbilical cord infection among neonates born in Petit-Goâve, Haiti. Phase 1: Focus Groups to determine traditional cord care practices and explore the acceptability of substituting chlorhexidine use for cord care. Phase 2: Develop, implement and evaluate community campaign to encourage newborn cord care based on World Health Organization recommendations. Background: Sepsis is the third leading cause of neo- natal death worldwide. Bacterial infection in the umbilical cord is a leading cause of sepsis. Home births in low- income countries have increased risk for cord infection. These infections can be prevented by chlorhexidine application to the newborn’s umbilical cord stump during the first week of life which is a World Health Orga- nization (WHO) recommendation for infants delivered in the community setting in low-resource countries. When traditional substances are applied to the cord, risk of neonatal cord infections increase by 29% to 62%, depending on the substance applied. Despite recom- mendations, chlorhexidine use has not been initiated in Haiti. Benefits of Chlorhexidine use in Petit- Goâve, Haiti may be particularly important due to high rates of neonatal mortality (25.5) home deliveries (64%), and poverty throughout the country. No study has ex- amined traditional cord care or the acceptability of chlorhexidine use in Haiti, the poorest country in the Western Hemisphere. Methods: Approval was granted by the University and the Haitian Bioethics Committee. Phase 1: a descriptive qualitative study of 5 focus groups, each session lasting 3 hours; 10 participants per group including pregnant women and elders, women with a child 2 y/o or younger, traditional/herbal healers and Vodou Priests/priestesses, traditional birth atten- dants (TBAs), community health workers (CHWs). Haitian facilitator and note taker transcribed record- ings from Haitian Creole to French to English. Within and cross-case analysis used to identify stakeholder expressed themes. Phase 2: an acceptability study. A community behavior-change campaign was devel- oped and implemented introducing chlorhexidine application to mothers, TBAs and CHWs. Eligible mothers were at least 18 years of age, experienced an uncomplicated delivery and gave birth to a healthy baby 7-10 days old. A survey was used with a cohort of the first 200 eligible women who delivered at home which avoided selection bias. Recruitment and enrollment of mothers occurred in their home one week post-delivery during a routine newborn visit by the CHW. To evaluate the success- ful adoption of chlorhexidine application, two primary outcomes were examined: whether women received the message to use chlorhexidine, and whether women adhered to the instructions to apply chlorhexidine for seven days or until cord separa- tion. Descriptive statistics were used to describe the study sample and use of chlorhexidine. Unadjusted and adjusted regression analyses were used to deter- mine factors related to adherence to the chlorhexidine application and use of traditional cord care practices. Data was de-identified. Results: Phase one: All groups believed covering a newborn’s umbilical cord with substances or a cloth or both protects against evil spirits carried in the air [wind] and that susceptibility to illness increases if the cord is left “open.” Traditional substances applied to a newborn’s cord were identified as healing and/or pro- tective: burnt nutmeg, dirt from the threshold of their home, crushed charcoal, ash, burned cotton, palm oil, leaves, animal excrement and mother’s urine. Phase 2: Mothers (98%) heard about using chlorhexidine, found it easy to apply and followed application instruc- tions. Few mothers (9%) reported co-application of an unhygienic substance to the cord site which included powder or dust; none reported using excrement; 72% of mothers continued to apply cloth abdominal cord coverings. Conclusion: The campaign was successful in reach- ing mothers and achieving chlorhexidine use versus unhygienic substance application. It can also provide www.jpedhc.org July/August 2018 331