A reaction paper on the Journal Article entitled Knowledge of danger signs in

newborns and health seeking practices of mothers and care givers in Enugu
state, South-East Nigeria by Uchenna Ekwochi, Ikenna K Ndu, Chidiebere DI
Osuorah2, Ogechukwu F Amadi, Ifeyinwa B Okeke, Ejike Obuoha, Kenechi S Onah,
Ikenna Nwokoye, Odutola I Odetunde and Nnenne I Obumneme-Anyim.

Submitted by: Merhan A. Muksan, R.N

The newborns are considered to be the most vulnerable group in any community.
Therefore, prompt and appropriate interventions should be done when they are stricken
with common childhood illnesses. The Journal targets to assess the perception of
mothers and/or caregivers of dangers signs in newborns and their knowledge of the
World Health Organization recognized danger. The study revealed that knowledge of at
least one danger of sign in the new born considerably increased the likelihood of the
mother and/or caregiver to seek care in health facilities.

According to the WHO, 5.6 million children under the age of 5 years died in 2016. This
translates into 15 000 under-five deaths per day. More than half of these deaths were
due to preventable conditions where access to simple and affordable interventions was
possible. Leading causes of death in children under-5 years are preterm birth
complications, pneumonia, birth asphyxia, diarrhoea and malaria.

A child's risk of dying is highest in the first 28 days of life (the neonatal period).
Improving the quality of antenatal care, care at the time of childbirth, and postnatal
care for mothers and their newborns are all essential to prevent these deaths. Globally
2.6 million children died in the first month of life in 2016. There are approximately 7
000 new born deaths every day, amounting to 46% of all child deaths under the age of
5-years.

The world has made substantial progress in child survival since 1990. The global under-
5 mortality rate has dropped by 56 per cent from 93 deaths per 1000 live births in 1990
to 41 in 2016. Nonetheless, accelerated progress will be needed in more than a quarter
of all countries, to achieve the Sustainable Development Goal (SDG) target (1) on
under-five mortality by 2030. Meeting the SDG target would reduce the number of
under-5 deaths by 10 million between 2017 and 2030.

WHO calls on to address health equity through universal health coverage so that all
children are able to access essential health services without undue financial hardship.
Moving from “business as usual” to innovative, multiple, and tailored approaches to
increase access, coverage, and quality of child health services will require strategic
direction and an optimal mix of community and facility based care. Health sector and
multisectoral efforts are also needed to overcome the inequalities and the social
determinants of health.

The study done by Uchenna Ekwochi and group also revealed that apart from
knowledge of at least one sign, most maternal variables recognized as favorable
determinants of child survival (e.g maternal education, age and higher socio-economic
status) were not significantly associated with knowledge of WHO designated danger
signs and subsequent decision to seek care.

The study concludes that there is a need to consolidate the teaching of expectant
mothers across all maternal socio-demographic variables on these danger signs and the
most appropriate measures to take when they occur. This teaching should specifically
focus on how to recognize danger signs and the most appropriate action to take
especially in rural communities where expert medical help may not be within immediate
reach.

Appropriate health seeking behavior is of prime importance and is a pivotal in the well-
being of the individual as well as the community. Intense awareness generation along
with counselling the local people of eminence on benefits of timely and appropriate
health seeking behaviour, both in preventive and curative aspects, may lead to the
desired health outcomes.
Unfortunately, the problem also exists in our community here in Zamboanga City. A
total of number of 26 deaths in newborns was registered in the year 2013 (Rate per
1,000 Live Births) as per CHO-Zamboanga City, which is an alarming rate considering
that there is already an implementation of IMCI (Integrated Management of Childhood
Illnesses) in both the rural and urban health units in the city.

There are no studies done yet in Zamboanga City focusing on the assessing level of
knowledge of dangers signs among newborns and health seeking behaviors among
Mothers. Most especially to those who are belonging to the low educational and income
status such as the indigenous people of Badjaos. This tribe is known as the Sea Gypsies
or Sea Nomads who for thousand of years are still living in the sea where they are free
from everyday rejection and hardship brought about upon by other tribes that live on
land. Due to the frightening health situation among children in Zamboanga City plus the
living condition of Badjaos, the rates of various infections among the tribe population
are heightened.

I am personally interested to investigate this problem and willing produce a mixed

quanti-qualitative study focusing on the level of knowledge on dangers signs and to
assess the health seeking behaviors of Badjao Mothers and/or Caregivers with under-
five children. I will use this journal/article as one of my related literature of the study.