Awareness about neonatal danger signs among mothers in a tertiary health center in Madhesh Province Nepal: A cross-sectional study

This study assessed maternal awareness of neonatal danger signs among 440 postnatal mothers attending Janaki Medical College and Teaching Hospital, Madhesh Province, Nepal. A descriptive cross-sectional design was employed from April 2023 to March 2025 using a structured, interviewer-administered questionnaire based on WHO guidelines. Overall, 61.6% of mothers demonstrated low awareness, identifying fewer than four danger signs. Fever (72.5%), jaundice (62.3%), and rapid or difficult breathing (55.3%) were the most frequently recognized signs, while knowledge of convulsions, chest indrawing, cold extremities, and low body temperature remained notably limited. Maternal education (p < 0.001), gravida status (p = 0.010), ANC attendance (p < 0.001), and household income (p = 0.005) showed significant associations with awareness, whereas age, occupation, family structure, and religion did not. Subgroup analyses confirmed the strong influence of educational level, caste, and number of ANC visits on awareness. Despite high ANC and institutional delivery rates, substantial knowledge gaps persist. Strengthening standardized maternal counselling during ANC and postnatal visits is essential to improve early recognition of neonatal illness and prevent avoidable morbidity and mortality Keywords: Neonatal danger signs, postnatal mothers, awareness, Madhesh Province