ABSTRACT

Introduction: Neonatal jaundice is one of the most common health problems affecting newborns worldwide and remains a significant cause of neonatal morbidity and mortality, particularly in developing countries. Although the condition is often treatable when detected early, lack of adequate maternal knowledge and inappropriate practices can lead to delayed diagnosis and severe complications. Understanding the level of knowledge and preventive practices among pregnant women is therefore essential for improving neonatal outcomes.

Objectives: The study aimed to assess the knowledge and practices of pregnant women regarding the prevention of neonatal jaundice at the Cité de Palmiers District Hospital in Douala. Specifically, it sought to determine the level of knowledge of pregnant women on neonatal jaundice prevention, evaluate their preventive practices, and identify socio-demographic factors influencing knowledge and practices.

Methods: A descriptive cross-sectional study design was used. The study involved 100 pregnant women attending antenatal care at the Cité de Palmiers District Hospital. Data were collected using a structured questionnaire divided into sections on socio-demographic characteristics, knowledge, preventive practices, and exposure to health education. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 26. Descriptive statistics such as frequencies and percentages were used, while Chi-square tests were applied to determine associations between socio-demographic factors and knowledge or practices, with statistical significance set at p < 0.05.

Results: The findings showed that 72% of respondents had heard of neonatal jaundice, and 56% correctly identified it as yellowing of the skin and eyes of a newborn. About 54% knew that excess bilirubin in the blood causes neonatal jaundice, while 68% recognized early breastfeeding as a preventive measure. Overall, the respondents demonstrated moderate knowledge of neonatal jaundice. In terms of practices, 78% attended antenatal care regularly, 85% indicated they would seek hospital care immediately if their baby developed jaundice, and 88% intended to initiate breastfeeding within the first hour after delivery. However, 40% still considered using traditional or herbal remedies, indicating the persistence of cultural practices. Statistical analysis showed that education level and occupation were significantly associated with preventive practices, while age and education level significantly influenced knowledge (p < 0.05).

Conclusion: The study revealed that pregnant women attending the Cité de Palmiers District Hospital had moderate knowledge and generally positive preventive practices regarding neonatal jaundice. However, knowledge gaps and reliance on traditional remedies still exist, which may delay appropriate treatment and increase the risk of complications among newborns.

Recommendations: The study recommends strengthening health education on neonatal jaundice during antenatal care, improving community awareness programs, and encouraging early hospital consultation and avoidance of traditional remedies to enhance prevention and early management of neonatal jaundice.

Keywords: Neonatal jaundice, maternal knowledge, preventive practices, pregnant women, antenatal care, newborn health, Cameroon.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Neonatal jaundice (hyperbilirubinemia) is among the most common health problems in newborns worldwide, and remains a major cause of neonatal morbidity and mortality, especially in low- and middle-income countries. Globally, each year, hundreds of thousands of newborns are affected by severe jaundice, and many suffer complications such as bilirubin encephalopathy, long-term neurological damage, or even death when diagnosis and treatment are delayed (Slusher & Olusanya, 2015; WHO, 2012). Although jaundice can be effectively treated if detected early, many newborns in developing countries still suffer due to limited awareness and access to care.

In sub-Saharan Africa, the burden is particularly high. A systematic review and meta-analysis estimated that roughly 28.1% of neonates in this region develop hyperbilirubinemia during the neonatal period, though rates vary considerably depending on the country and local conditions (Khawaja et al., 2016). Factors such as prematurity, low birth weight, blood-group incompatibilities (e.g. ABO or Rh), enzyme deficiencies (e.g. G6PD), and neonatal infections contribute significantly to the high incidence (Khan et al., 2018; Sock et al., 2020).

In Cameroon, neonatal jaundice remains a common and important concern. A hospital-based retrospective study over five years found a neonatal jaundice incidence of 19.7% among admitted neonates, with infections responsible for 70.9% of cases, followed by physiologic jaundice (Chiabi et al., 2020). Another recent hospital-based study in the Fako Division reported a prevalence of 15.2% among newborns in selected health facilities, with a large proportion of cases noticed within the first week of life (Ayamba et al., 2023). These findings suggest that neonatal jaundice is not rare and continues to burden neonatal health in Cameroon.

Further, related research shows that neonatal jaundice is a frequent complication among hospitalised neonates: in a recent review of neonatal admissions, jaundice was present in roughly 17% of cases (Moguenyem & colleagues, 2024). While nationwide neonatal mortality has improved, the rate remains high in 2015; it was estimated at 29 to 31 per 1000 live births (Mungyeh et al., 2014). High neonatal mortality suggests that many conditions, including jaundice may still contribute substantially to early infant deaths.

Several factors influence the knowledge and practices of pregnant women regarding neonatal jaundice prevention. Socio-demographic factors such as age, educational level, occupation, and parity have been shown to significantly affect maternal understanding of neonatal health conditions (Ndu, Egbuonu, & Ulasi, 2016). Educated mothers tend to have better awareness and adopt healthier preventive practices than those with lower educational levels. Antenatal care (ANC) attendance is another key factor; mothers who attend ANC regularly are more likely to receive health education on neonatal conditions, including jaundice (Okafor et al., 2020). Similarly, exposure to health education through healthcare workers, media, and community programs plays a major role in shaping preventive behaviour and early recognition of neonatal illnesses (Akinbami et al., 2022).

Despite these data, there is a lack of published studies specifically on knowledge and preventive practices of pregnant women regarding neonatal jaundice in most parts of Cameroon, and little to no in Douala or the Littoral region. This gap prevents efforts to design targeted maternal education or prevention strategies, particularly in urban hospital settings. Given the high and variable prevalence of neonatal jaundice across Cameroon, understanding what expectant mothers know and do about prevention is crucial, especially at facilities like the Cité de Palmiers District Hospital in Douala, where many women attend antenatal care.

1.2 Statement of the Problem

Neonatal jaundice is a prevalent condition that poses significant health risks to newborns, particularly in developing regions like Cameroon, where it remains a leading cause of morbidity and mortality. Despite the recognised dangers, many pregnant women have limited knowledge about the causes, symptoms, and preventive measures related to neonatal jaundice. This gap in understanding can lead to delayed recognition and treatment, increase the condition’s severity, and increase the risk of serious complications such as long-term neurological damage.

Although various studies highlight the burden of neonatal jaundice, there is a notable lack of focused research on the knowledge and practices of pregnant women regarding its prevention, particularly in urban areas like Douala. Understanding these aspects is crucial, as it can inform targeted educational initiatives and healthcare interventions. Therefore, this study aims to investigate the extent of knowledge and the practices adopted by pregnant women at the Cité de Palmiers District Hospital to identify the factors influencing their understanding and actions concerning the prevention of neonatal jaundice.

1.3 Research Questions

1.3.1Main Research Question

What is the level of knowledge and practice regarding the prevention of neonatal jaundice among pregnant women at the Cité de Palmiers District Hospital, Douala?

1.3.2 Specific Research Questions

1. What is the level of knowledge of pregnant women on the prevention of neonatal jaundice?
2. What are the practices of pregnant women concerning the prevention of neonatal jaundice?

1.4 Research Objectives

1.4.1 Main Objective

To assess the knowledge and practice of pregnant women regarding the prevention of neonatal jaundice at the Cité de Palmiers District Hospital, Douala.

1.4.2 Specific Objectives

1. To determine the level of knowledge of pregnant women on the prevention of neonatal jaundice.
2. To evaluate the practices of pregnant women in relation to the prevention of neonatal jaundice.

1.5 Research Hypothesis

Null Hypothesis (H₀): There is no significant relationship between pregnant women’s knowledge and practice regarding the prevention of neonatal jaundice.

Alternative Hypothesis (H₁): There is a significant relationship between pregnant women’s knowledge and practice regarding the prevention of neonatal jaundice.

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