Prevalence and factors associated with skin-to-skin contact (SSC) practices: findings from a population-based cross-sectional survey in 10 selected districts of Bangladesh

Abstract Background: Skin-to-skin contact (SSC) is one of the eight proven Essential Newborn Care (ENC) practices that improve newborn survival. Despite having myriads of benefits, it is one of the least used ENC interventions especially in the low and middle-income countries (1% to 74%). In Bangladesh, the prevalence of SSC practices was 26% in 2014. To advance the use of this intervention, it is important to assess its prevalence within the population and to identify factors that facilitate or inhibit SSC practices in Bangladesh. Methods: We used baseline household survey data of USAID’s MaMoni MNCSP project conducted in 10 districts of Bangladesh in 2019. Our analysis included 13,695 recently delivered women (RDW) with a live birth outcome. Our primary outcome was the mother’s reported SSC practice. We examined various antepartum, intrapartum, newborn, and sociodemographic factors associated with SSC using a multivariable generalized linear model. Our findings were reported using adjusted Prevalence Risk Ratios (aPRRs) and 95% Confidence Intervals (CIs). Results: Overall, 28% of RDW reported practicing SSC across the 10 surveyed districts. Our multivariable analysis showed that public facility delivery (aPRR 2.01; 95%CI: 1.80, 2.26), private facility delivery (aPRR 1.23; 95%CI: 1.06, 1.42) and 4 antenatal care (ANC) visits at least one from a medically trained provider (MTP) (aPRR 1.17; 95%CI: 1.03, 1.26) had a significant positive association with SSC practices. Caesarean section (aPRR 0.64; 95%CI: 0.56, 0.73) had a significant negative association with SSC practices. We also found a significant positive association of SSC practices with mothers’ who perceived the birth size of their baby to be small, mothers with a higher education level (≥10 years), and mothers from households in the highest wealth quintile. Conclusions: The prevalence of SSC is very low in the surveyed districts of Bangladesh. Considering the factors associated with SSC, relevant stakeholders need to increase their efforts on improving ANC and facility delivery coverages as well as improving SSC practices in the facilities especially after caesarean deliveries. Countries with a high burden of home deliveries also need to emphasize community-based interventions and increasing coverage of skilled birth attendance for improving this life-saving intervention.