Mukunya et al., 

Abstract:

Knowledge of key decision makers and actors in newborn care is necessary to ensure that
health interventions are targeted at the right people. This was a cross-sectional study carried out
in Lira district, Northern Uganda. Multivariable logistic regression was used to determine factors
associated with mothers being the key decision maker regarding where to give birth from and when
to initiate breastfeeding. Fathers were the key decision makers on the place of birth (54.3%, n =
505) and on whether to seek care for a sick newborn child (47.7%, n = 92). Grandmothers most
commonly bathed the baby immediately after birth (55.5%, n = 516), whereas mothers and health
workers were common decision-makers regarding breastfeeding initiation. Predictors for a mother
being the key decision maker on the place of birth included: Mother having a secondary education
(AOR 1.9: 95% C.I (1.0–3.6)) and mother being formally employed (AOR 2.0: 95% (1.5–2.9)). Mothers,
fathers, grandmothers, health-workers, and traditional birth attendants were the most influential in
the selected newborn care practices. Programs that aim to promote newborn care need to involve
husbands, grandmothers, and health workers in addition to mothers.

Keywords: newborn; neonatal; implementation; influencers; actors; decision-making; Uganda;
post-conflict; behavior

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