Enablers and Barriers to Chlorhexidine Use in Umbilical Cord Care: Voices of Care Givers and Healthcare Providers in Selected Counties in Kenya

This mixed-methods study explored barriers and enablers to the use of Chlorhexidine (CHX) for umbilical cord care in Kwale, Vihiga, and Machakos counties in Kenya. Among 582 surveyed caregivers, only 1.3% had used CHX, with most relying on alternatives like methylated spirits, salty water, herbal extracts, and even harmful substances like cow dung and soil. While health workers were fully aware of CHX, only 38.7% of caregivers had heard of it. Key enablers of CHX use included faster healing, ease of use, hospital infection control, and influence from decision-makers, while barriers included low caregiver awareness, cultural taboos, inadequate CHV training, unclear user guidelines, and frequent stockouts. Health workers also cited poor dissemination of guidelines and procurement challenges. The study recommends community education, improved supply chain management, and stronger advocacy to increase CHX uptake and ensure safer newborn care practices.

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