Effect of the Uganda Newborn Study on care-seeking and care practices : a cluster-randomised controlled trial

Autor: Patrick Aliganyira, Gertrude Namazzi, Joseph Akuze, George Pariyo, Elizabeth Ekirapa-Kiracho, Stephan Peterson, Hanifah Naamala Sengendo, Kate Kerber, Peter Waiswa, Joy E Lawn, Karin Källander
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Male
Rural Population
Pediatrics
neonatal mortality
Child Health Services
Psychological intervention
Breastfeeding
law.invention
community health workers
Health facility
Randomized controlled trial
kangaroo mother care
law
Pregnancy
Medicine
Cluster Analysis
Uganda
Cluster randomised controlled trial
Community Health Services
education.field_of_study
Health Policy
lcsh:Public aspects of medicine
health system strengthening
maternal care
newborn care
randomised controlled trial
Public Health
Global Health
Social Medicine and Epidemiology
Middle Aged
House Calls
Female
Adult
medicine.medical_specialty
Adolescent
Population
Young Adult
Humans
Maternal Health Services
education
Developing Countries
business.industry
Public Health
Environmental and Occupational Health
Infant
Newborn
Infant
lcsh:RA1-1270
Newborn Health in Uganda
Patient Acceptance of Health Care
medicine.disease
Infant mortality
Folkhälsovetenskap
global hälsa
socialmedicin och epidemiologi
Socioeconomic Factors
Family medicine
Infant Care
Rural Health Services
business
Zdroj: Global Health Action
Global Health Action, Vol 8, Iss 0, Pp 1-11 (2015)
Popis: Background : Care for women and babies before, during, and after the time of birth is a sensitive measure of the functionality of any health system. Engaging communities in preventing newborn deaths is a promising strategy to achieve further progress in child survival in sub-Saharan Africa. Objective : To assess the effect of a home visit strategy combined with health facility strengthening on uptake of newborn care-seeking, practices and services, and to link the results to national policy and scale-up in Uganda. Design : The Uganda Newborn Study (UNEST) was a two-arm cluster-randomised controlled trial in rural eastern Uganda. In intervention villages volunteer community health workers (CHWs) were trained to identify pregnant women and make five home visits (two during pregnancy and three in the first week after birth) to offer preventive and promotive care and counselling, with extra visits for sick and small newborns to assess and refer. Health facility strengthening was done in all facilities to improve quality of care. Primary outcomes were coverage of key essential newborn care behaviours (breastfeeding, thermal care, and cord care). Analyses were by intention to treat. This study is registered as a clinical trial, number ISRCTN50321130. Results : The intervention significantly improved essential newborn care practices, although many interventions saw major increases in both arms over the study period. Immediate breastfeeding after birth and exclusive breastfeeding were significantly higher in the intervention arm compared to the control arm (72.6% vs. 66.0%; p =0.016 and 81.8% vs. 75.9%, p =0.042, respectively). Skin-to-skin care immediately after birth and cord cutting with a clean instrument were marginally higher in the intervention arm versus the control arm (80.7% vs. 72.2%; p =0.071 and 88.1% vs. 84.4%; p =0.023, respectively). Half (49.6%) of the mothers in the intervention arm waited more than 24 hours to bathe the baby, compared to 35.5% in the control arm ( p
Databáze: OpenAIRE
Externí odkaz: