Clean Cord Cutting

The indicator measures the proportion of children whose cord was cut with a new or sterile blade or instrument, reducing the risk of cord infection. The indicator should be used only for home deliveries as women who delivered at a facility are not likely to know what was used to cut the cord.

Collect the following data by conducting individual interviews with a representative sample of mothers of children aged 0-11.99 months:

RECOMMENDED SURVEY QUESTIONS (Q) AND POSSIBLE ANSWERS (A)

Q1: After you last delivery, do you remember what instrument was used to cut the cord?

A1:

1) new razor blade

2) used razor blade

3) new scissors

4) used scissors

5) knife

6) reed

7) other – specify: …………………….

8) does not remember

(ask the following question only if the respondent remembers the instrument used)

Q2: Do you remember whether the [specify the instrument used] was boiled prior to being used for cutting the cord?

A2:

1) yes, was boiled

2) no, was not boiled

3) does not remember

As “clean cord cutting” can be considered:

1) using new razor blade or scissors (answers 1 and 3)

2) using razor blade/scissors that were previously boiled

Calculate the indicator’s value by dividing the number of respondents reporting clean cord cutting by the total number of respondents (exclude those who did not remember) and multiplying the result by 100.

Disaggregate the data by the place of delivery (at home, in a health centre, in a hospital), presence of a skilled birth attendant during delivery (present/ absent; use for home deliveries only), socio-economic characteristics (level of education, wealth quintile) and location (rural/ urban).

1) Since mothers might not remember exactly the information your survey is asking about, consider conducting as many interviews as possible in pairs consisting of the mother and a birth attendant/ relative who attended the delivery/ who took care of the mother. While using such an approach will take you more time, it will very likely result in more accurate data. If none of the listed options are likely to provide accurate data, consider changing the indicator to “% of  [specify: health facilities / birth attendants] always using clean cord cutting” and collecting the required data from the target health facilities’ staff/ birth attendants.

2) The most common recommendation is interviewing mothers of children aged 0-23 months. However, this assumes that the mothers will remember for up to two years the information your survey is asking about. Since this is not very likely, IndiKit recommends using for this indicator a shorter recall period by interviewing mothers of children aged 0-12 months. Use it only if the data is supposed to be used purely for the purpose of your intervention (i.e. making programming decisions, measuring its results, etc.) and does not need to be comparable with the statistics of other stakeholders which use longer recall period. 

3) This indicator relies on accurate age assessment. Since people often do not remember the exact dates of their children’s birth, the data collectors should always verify the child’s age. This can be done by reviewing the child’s birth certificate, vaccination card or another document; however, since many caregivers do not have such documents (and since they can include mistakes), it is essential that your data collectors are able to verify the child’s age by using local events calendars. Read FAO’s Guidelines (see below) to learn how to prepare local events calendars and how to train data collectors in their correct use.