Engagement of the Community, Traditional Leaders, and Public Health System in the Design and Implementation of a Large Community-Based, Cluster-Randomized Trial of Umbilical Cord Care in Zambia
| Autor: | Davidson H. Hamer, Julie M. Herlihy, Kebby Musokotwane, Boyd Mwangelwa, Bowen Banda, Kojo Yeboah-Antwi, Chipo Mpamba, Portipher Pilingana, Jonathon L Simon, Donald M. Thea, Caroline Grogan, Katherine Semrau |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Zambia Traditional authority Umbilical Cord law.invention Formative assessment Randomized controlled trial Pregnancy law Virology medicine Humans Cluster randomised controlled trial Community engagement business.industry Public health Chlorhexidine Postpartum Period Community Participation Infant Newborn Articles Bacterial Infections medicine.disease Infectious Diseases Family medicine Anti-Infective Agents Local Female Parasitology business Public Health Administration Postpartum period |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 92:666-672 |
| ISSN: | 1476-1645 0002-9637 |
| DOI: | 10.4269/ajtmh.14-0218 |
| Popis: | Conducting research in areas with diverse cultures requires attention to community sensitization and involvement. The process of community engagement is described for a large community-based, cluster-randomized, controlled trial comparing daily 4% chlorhexidine umbilical cord wash to dry cord care for neonatal mortality prevention in Southern Province, Zambia. Study preparations required baseline formative ethnographic research, substantial community sensitization, and engagement with three levels of stakeholders, each necessitating different strategies. Cluster-specific birth notification systems developed with traditional leadership and community members using community-selected data collectors resulted in a post-natal home visit within 48 hours of birth in 96% of births. Of 39,679 pregnant women enrolled (93% of the target of 42,570), only 3.7% were lost to follow-up or withdrew antenatally; 0.2% live-born neonates were lost by day 28 of follow-up. Conducting this trial in close collaboration with traditional, administrative, political, and community stakeholders facilitated excellent study participation, despite structural and sociocultural challenges. |
| Databáze: | OpenAIRE |
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