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Abstract

Neonatal tetanus is a life-threatening infection that may occur when the umbilical cord is cut with non-sterile instruments or when inappropriate cord care practices are applied. Improper cord care may also affect the duration of cord separation. This study aimed to explore umbilical cord care practices at the primary healthcare level and evaluate their role in preventing neonatal infection. A qualitative study with a descriptive case study approach was conducted involving midwives who routinely performed neonatal cord care in primary healthcare settings. Data were collected through observations and interviews and analyzed descriptively. The findings showed that midwives understood the objectives of cord care and the risks of infection. However, most participants continued to use 70% alcohol as the primary method of cord care. All observed newborns remained healthy, their umbilical cords dried appropriately, and no signs of infection were identified during the observation period. Cord care was consistently performed using sterile cotton and 70% alcohol, with cleaning from the base toward the tip of the cord once or twice daily until cord separation. Although the observed practice resulted in satisfactory clinical outcomes, it differs from the recommendations of the Indonesian Ministry of Health and the World Health Organization, which advocate dry cord care as the standard method. Greater adherence to evidence-based guidelines is recommended.