The Acceptability of Clean Delivery Kits on the Atlantic Coast of Nicaragua: A Focused Ethnography.

Anecdotal reports suggest rates of puerperal sepsis/umbilical cord infection in the Southern Atlantic Autonomous Region (RAAS) of Nicaragua are high, as maternal/infant mortality rates are. Clean delivery kits (CDKs; sealed containers, clean razor blades, soap, string to tie umbilical cords, and clean plastic sheeting) have been shown to decrease perinatal infection rates in low-income countries. Participant observation, focus groups, and key informant interviews with parties involved in delivery practices and policies were conducted in this focused ethnography to determine the cultural acceptability of CDKs for midwives in the RAAS. The CDKs were acceptable in their contents, although remain controversial. Although evidence points to deliveries taking place at home without the use of sterile equipment, the Ministry of Health policy is for deliveries to take place in hospitals/health clinics.