Implementation of the Policy on the Use of Chlorhexidine in Umbilical Cord Care in Ghana: Perspectives of Midwives

Abstract

A newly cut umbilical cord can be a pathway for bacteria that can cause newborn sepsis and death. The Ministry of Health, through the Ghana Health Service, introduced a policy to replace methylated spirit with 7.1% chlorhexidine gluconate in umbilical cord care. This study used an exploratory descriptive design, involving 23 midwives purposefully sampled from the Salaga Government Hospital. The study aimed to explore the perspectives of midwives regarding the implementation of the policy on the use of chlorhexidine in umbilical cord care. The data collection strategy was structured interview guide. The analysis of the data gathered yielded four main themes and eight sub-themes. The findings showed that midwives’ practices regarding chlorhexidine use involved the application technique of chlorhexidine, chlorhexidine application at home setting, and education on chlorhexidine given to the mothers before discharge. The participants believed that the use of chlorhexidine in cord care had significantly reduced the number of cord sepsis cases recorded in the neonatal intensive care unit. Some of the challenges expressed by the participant were that the mothers apply chlorhexidine in the baby’s eye and continue to mix chlorhexidine along with tetracycline eye ointment. The study concluded that chlorhexidine was used by participants in the hospital setting. It is recommended that midwives establish good rapport with patients to promote trust between them and the patients to reduce the chances of patients going home to apply other substances apart from chlorhexidine. Also, midwives should constantly remind management about the limited availability of chlorhexidine in the hospital for supply. Finally, future studies could use a quantitative approach to address the challenges confronting midwives' use of chlorhexidine in the hospital.