Assessment of knowledge on causes and care of neonatal jaundice at the Nigerian primary and secondary health institutions

Olusegun Joseph Adebami


Background: Neonatal jaundice is the most common condition that requires medical attention in new-borns. However, missed diagnosis of jaundice, poor monitoring, and prescriptions of wrong and ineffective medications by the health workers for jaundice are known to be responsible for the persistence of acute bilirubin encephalopathy in the sub region.  Therefore, the aim of the present study was therefore to assess the knowledge in the care of neonatal jaundice at the primary and secondary health care delivery in Nigeria so as to improve it.

Methods: A cross-sectional study conducted at 12 local government primary health and maternity centers and 2 state owned general hospitals (secondary health facilities) in Osun State, Southwest Nigeria between January and June 2014. Consent was obtained from the health workers at the health facilities. A structured questionnaire was administered to all the staffs on duty and during the shifts of duty. The questionnaire contained questions to assess the knowledge of the health workers with regard to neonatal jaundice causes, treatment and complications. Staff judgment on the effectiveness of methods and drugs being prescribed were also assessed.

Results: One hundred and forty one (67.5 percent) were primary health care workers and 68 (32.5percent) were staff in secondary health care facilities. There was significantly better understanding of causes, management and complications of neonatal jaundice among secondary  health care workers than primary health care workers (p at least 0.007). Common pharmacological agents prescribed were Ampiclox (Ampicillin-Claxacillin formulation), Glucose water, Multivitamins, phenobarbitone, other antibiotics and injections at both health care levels.

Conclusions: There is therefore urgent need to train health workers of all cadres on causes, care, effective treatment and complications of neonatal jaundice to reduce the high prevalence of bilirubin encephalopathy. Facilities like effective phototherapy units should be made available at health facilities and training centres.



Assessment, Knowledge, Health workers, Neonatal jaundice, Nigeria

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Slusher TM, Olusaniya BO. Neonatal jaundice in low- and middle-income countries. In: Stevenson DK, Maisels MJ, and Watchko JF. Care of the jaundiced neonate. New York: McGraw-Hill; 2012:263-73.

Adebami OJ. Factors associated with the incidence of acute bilirubin encephalopathy in Nigerian population. J Pediatr Neurol 2011;9:347-353.

Olusoga BO, Olusoji JD. Neonatal jaundice and its management: knowledge, attitude and practice of community health workers in Nigeria. BMC Public Health 2006, 6:19doi:10.1186/1471-2458-6-19.

Ekanem EE and Young MU. Knowledge of the causes and management of neonatal jaundice by primary health care staff. Nig J Paediatr 1994;21(2)37-42.

Adebami OJ. Appraisal of maternal knowledge of neonatal jaundice in Ilesa, South-western Nigeria: What implications for persistence of acute bilirubin encephalopathy in developing countries. Basic Res J Med Clin Sc 2015;4(6):156-16.

Su Yuen Ng and Yee Chong. What do mothers know about neonatal jaundice? Knowledge, attitude and practice of mothers in Malaysia. Med J Malaysia 2014;69(6):252-256.

Boo NY, Gan CY, Gian YW, Lim KS, Lim MW, Krishna-Kumar H: Malaysian mothers’ knowledge & practices on care of neonatal jaundice. Med J Malaysia 2011, 66:239-243.

Khalesi N, Rakhshani F. Knowledge, attitude and behaviour of mothers on neonatal jaundice. J Pak Med Assoc 2008;58:671-4.

Egube BA, Ofili AN, Isara AR, Onakewhor JU: Neonatal jaundice and its management: knowledge, attitude, and practice among expectant mothers attending antenatal clinic at University of Benin Teaching Hospital, Benin City, Nigeria. Niger J Clin Pract 2013, 16:188-194.

Ogunlesi TA, Fetuga MB, Adekanmbi AF. Mothers’ knowledge about birth asphyxia: The need to do more! Niger J Clin Pract 2013;16:31-6.

Owa JA, Taiwo O, Adebiyi JAO, Dogunro SA. Neonatal jaundice at Wesley Guild Hospital, Ilesa and Ife State Hospital, Ile-ife. Nig J Paediatr 1989;16:23-30.

Chan TK, Todd D, Tso SC. Drug-induced haemolysis in glucose-6-phosphate dehydrogenase deficiency. BMJ 1976;2:1227-29.

Effiong CE, AimakuVE, Bienzle V, Oyedeji GA, Ikpe DE. Neonatal jaundice in Ibadan: Incidence, aetiological factors in babies born in hospitals. J Natl Med Assoc 1975;67:208-13.

Obasa TO, Mokuolu OA, Ojuawo A. Glucose 6 phosphate dehydrogenase levels in babies delivered at the University of Ilorin teaching hospital. Nig J Paediatr 2011;38(4)165-169.

Wynn JL, Levy O. Role of innate host defences in susceptibility to Early- onset neonatal sepsis Clin Perinatol 2010: 37(2)307-37.

National Institute for Health and Clinical Excellence: Neonatal jaundice. (Clinical guideline 98.) 2010. Reviewed August 2014. (Accessed May 11, 2015).

Ibe BC. Neonatal jaundice. In: Azubuike JC and Nkanginieme KEO (Eds). Paediatrics and Child Health in a Tropical region. African Educational Services, Owerri, Nigeria 2007;204-211.

Ogunlesi TA. Managing neonatal jaundice at the general practice and primary health care level: An overview. Nig J Paediatr 2004;31(2)33-38.

Poland RL, Osurea EM. Neonatal hyperbilirubinaemia In: Klaus MH, Fanaroff AA, eds. Care of the High risk neonata. WB Saunders Company, Philadelphia. 1986:239-256.

Olusanya BO, Imam ZO, Mabogunje CA, Emokpae AA, Slusher TM. Maternal satisfaction with a novel filtered-sunlight phototherapy for new-born jaundice in Southwest Nigeria BMC Paediatrics 2014, 14:180.

Bhutani VK, Committee on Fetus and New-born; American Academy of Paediatrics: Phototherapy to prevent severe neonatal hyperbilirubinemia in the new-born infant 35 or more weeks of gestation. Pediatrics 2011, 128:e1046-e1052.

Maisels MJ, McDonagh AF: Phototherapy for neonatal jaundice. N Engl J Med 2008, 358:920-928.

Bhutani VK, Cline BK, Donaldson KM, Vreman HJ: The need to implement effective phototherapy in resource-constrained settings. Semin Perinatol 2011, 35:192-197.

Cline BK, Vreman HJ, Faber K, Lou H, Donaldson KM, Amuabunosi E, Ofovwe G, Bhutani VK, Olusanya BO, Slusher TM: Phototherapy device effectiveness in Nigeria: irradiance assessment and potential for improvement. J Trop Pediatr 2013, 59:321-325.

Owa JA, Ogunlesi TA: Why we are still doing so many exchange blood transfusion for neonatal jaundice in Nigeria. World J Pediatr 2009, 5:51-55.

Okperi BO: Neonatal jaundice and birth asphyxia as major causes of cerebral palsy in Nigeria: are doctors’ wrong beliefs and practices part of the problem? Int J Med Biomed Res 2013, 2:226-230.