Promoting Delayed Cord Clamping in India to Address Iron Deficiency in Newborns: A Participatory Action Framework for Global Collaboration

Prater, Lyn

Anemia is a public health problem in India both in reproductive aged women and in children. Anemia has been linked to childhood stunting of growth and implicated in early mental growth and development. The practice of delayed cord clamping (DCC) at the time of delivery has been shown to significantly increase the amount of iron in the newborn through six months of life (Hutton & Hassan, 2007).

A project was planned and anchored on the precept of respect for human relationships with a participatory action research (PAR) philosophy underpinning all actions preceding, during and continuing after the implementation of this study to assess and promote DCC. The Knowledge to Action framework was used to design the project education and workshop sessions. A single group pre- and post-test design was utilized to evaluate knowledge and beliefs before and after the DCC workshop. A practice opportunity using the Mama Nataleäfor simulation followed completion of the pretest and a lecture on DCC. A post-test was completed immediately after the education and simulation exercise and then 9 months later. Data management and analyses were carried out using the statistical software package SPSS for Mac version 20.0 (SPSS Inc., Chicago, IL).

Thirty-one midwives participated in the program. Descriptive statistics describe the type of midwife and their practice patterns. Results indicate significant changes in knowledge, beliefs and practice related to DCC. Findings revealed that rural midwives were already practicing some form of DCC although they were not formally taught DCC in their pre-service education program. The use of simulation elucidated important questions and collaborative discussion about the practice of DCC that could have been a barrier to implementation if they had not been disclosed. Other practices related to the care of mothers and newborns during childbirth were observed and included in future training planned around those observations.