Table 5 Provision of essential newborn care practices described in interviews (Every Newborn Action Plan [5])

Immediate and thorough drying

They came and wiped the baby and then lay it down on my chest. (Secondary hospital, Mother, Vaginal Birth, 2nd baby)

They wipe the blood from the baby, and then they got a blanket and wrap it around the baby and put the baby in the cot. (Tertiary hospital, Mother, Vaginal Birth, 1st baby)

After they put the baby on my tummy, they clean the baby [with a cloth], and also me the mother, they both clean both of us. (Tertiary hospital, Mother, Vaginal Birth, 3rd baby)

We place the baby on the mother’s tummy and we have to wipe the baby’s face and mouth in case baby inhales or swallow particles. (Health centre, Community Health Worker)

I wipe the face and skin and rub until the baby is dry and then put the baby on the mother’s chest. Okay, now I cover the baby with a blanket and the mother will hold the baby and they both will sleep so I will let the baby stay there for a while (Tertiary hospital, Midwife)

Baby placed on mother’s chest after birth, skin-to-skin

Baby lie on my chest for roughly thirty to forty minutes (Tertiary hospital, Mother, Vaginal Birth, 2nd baby)

She got the baby and placed on my tummy (Rural hospital, Mother, Vaginal Birth, 6th baby)

The baby cried when delivered and then was placed on my chest. (Secondary hospital, Mother, Vaginal Birth, 2nd baby)

I didn’t have the opportunity to see my baby because I was in operation, maybe they operate on me, get the baby and they straight away gave it to the sister in charge of nursery … and they keep it in the nursery for one whole day until the next morning (Tertiary hospital, Mother, Married, Caesarean Section, 2nd baby)

When the baby is born we remove the baby and put the baby on the mother’s chest (Community health post, Community Health Worker)

When I deliver the baby, I firstly place baby on the mother’s belly and I tell her that her baby is a boy or a girl. I tell the mother to hug the baby and ask her if she is happy now that the pain is gone (Health centre, Community Health Worker)

Having the baby on top of the mother’s chest, they’re skin to skin because it is very important that the immune, the warmth from the mother passes to the baby. We try our utmost best not to remove the baby from the mother … We can leave the baby lying there on the mother for more than 90 minutes. (Secondary hospital, Midwife)

Delayed cord-clamping

Previously when the baby is born we cut the umbilical cord straight away but currently it has changed … we wait for the pulsation of the cord to stop and we cut the cord. (Health centre, Community Health Worker)

If we are very busy, we leave the baby on the mother’s chest and just wait for the cord to stop pulsating, clamp, cut … Just last month, I started realizing that lately we were not waiting for the cord to stop pulsating. As soon as the baby was born, the cord stopped pulsating immediately so I asked some trainee students, if they noticed what was happening. I mentioned this to them and they confirmed that ‘yes, it’s true, that they are no longer waiting for the cord to stop pulsating and they are cutting the cord straight away. (Tertiary hospital, Midwife)

We wait if the cord is still pulsating; we don’t cut. We wait until the cord stops pulsating and then we cut, wrap the baby and leave the baby with the mother so that we can continue with the mother. (Rural hospital, Midwife)

Early initiation of breastfeeding

She [health provider] moves the baby close for breastfeeding and then she leaves us. (Rural hospital, Mother, Vaginal Birth, 4th baby)

Later the baby is looking for breast milk. And I said, oh baby come out and looking for breast milk so I must feed the baby as soon as possible, and I give the baby breast milk. I know baby want to breastfeed and I breastfeed the baby quickly. I sleep the baby to my side on my hand and feed the baby with breast milk, and the baby started breastfeeding. (Secondary hospital, Mother, Vaginal Birth, 3rd baby)

They [health providers] told me to breastfeed the baby, I must breastfeed the baby, when the baby keeps on sucking the breast milk will come. (Secondary hospital, Mother, Vaginal Birth, 1st baby)

We tell the mother she can breast feed the baby if she sees that the baby is ready for feed. (Rural hospital, Midwife)

We keep the baby with the mother for breast feeding, baby can breast feed and after that we give immunisation. (Rural hospital, Midwife)

So after we clean the mother, we put the baby on her breast so that the baby can start to feed. While she is feeding the baby … We give advice on exclusive breast feeding, baby feeding, placenta, nutrition and diet, family planning and monthly immunization for the baby. Or if she feels any pain around her abdomen or pain during breastfeeding, then we reassure her and tell her, this is the involution of her uterus and also about her reproductive system. (Tertiary hospital, Midwife)