Table 2.

Standard and suboptimal practices of reported birth attendants

Type of care	Standard practices	Suboptimal practices
Antenatal care	High overall antenatal care attendance	Low complete antenatal care attendance
Type of birth attendant		Relatives attending births, especially in Luxor
Hygiene/clean delivery	Birth attendants washed hands before 75% of vaginal examinations and deliveries Sterile technique in cutting/tying cord	Delivery instruments cleaned before use in only half of cases Unsterile instrument used for cutting and household thread to tie umbilical cord No antiseptic on cord stump
Intrapartum and immediate newborn care		Complications delivered at home and private clinics High rate of use of forceps by obstetricians Use of forceps by dayas Pulling umbilical cord to facilitate delivery of the placenta Hanging by legs during resuscitation
Thermal control	Prompt thermal control postdelivery	Low skin-to-skin contact Delay in initial mother-newborn contact (>1 hour in half of cases), especially in Aswan High rate of hypothermia
Postnatal care	75% had postnatal visit with birth attendant
Care of high-risk newborns		Under-identification of low birthweight Lack of weighing
		Lack of communication with the mother about size of newborn
Prevention		Birth injury, especially in Aswan (17%), limb problems in Luxor (8%)