IMPACT OF MATERNAL HEALTH LITERACY ON NEONATAL OUTCOMES IN PUBLIC HOSPITALS OF PAKISTAN: A PROSPECTIVE OBSERVATIONAL STUDY
Keywords:
Apgar Score, Breastfeeding, Health Literacy, Illness Recognition, Maternal Education, Neonatal Health, PakistanAbstract
BACKGROUND: Maternal health literacy significantly influences neonatal outcomes, particularly in low- and middle-income countries where preventable neonatal mortality remains high. In Pakistan, limited maternal understanding of newborn care, breastfeeding, and illness recognition continues to impede neonatal health progress.
OBJECTIVE: To assess the impact of maternal health literacy on breastfeeding practices, illness recognition, and early neonatal health indicators among mothers delivering in public hospitals of Pakistan.
METHODOLOGY: A prospective observational study was conducted across four tertiary public hospitals in Pakistan from February to October 2023. A total of 420 postpartum mothers were enrolled using systematic random sampling. Maternal health literacy was measured using the Health Literacy Questionnaire (HLQ), while neonatal outcomes were assessed through Apgar scores, birth weights, breastfeeding initiation timing, and maternal illness recognition ability. Data were analyzed using SPSS version 26. Descriptive statistics, ANOVA, Pearson correlation, and logistic regression were applied, with p < 0.05 considered significant. Ethical approval was obtained from Jinnah Postgraduate Medical Centre (ERC No. JPMC/ERB/OBGYN/2023/172).
RESULTS: Among 420 mothers, 24.5% had inadequate, 29.3% marginal, 27.6% sufficient, and 18.6% excellent health literacy. Early breastfeeding initiation occurred in 88% of mothers with excellent literacy versus 35% among those with inadequate literacy. Higher maternal literacy correlated positively with neonatal Apgar scores (r = 0.48, p < 0.001) and illness recognition ability (r = 0.51, p < 0.001). Logistic regression revealed that mothers with high literacy were 3.4 times more likely to initiate breastfeeding within one hour (AOR = 3.42, 95% CI: 2.15–5.43, p < 0.001).
CONCLUSION: Maternal health literacy strongly influences neonatal health and care practices. Integrating literacy-focused education into antenatal and postnatal care programs can substantially improve neonatal survival and wellbeing in Pakistan.
KEY TERMS: Apgar Score, Breastfeeding, Health Literacy, Illness Recognition, Maternal Education, Neonatal Health, Pakistan
