An integrated newborn care kit (iNCK) to save newborn lives and improve health outcomes in Gilgit Baltistan (GB), Pakistan: study protocol for a cluster randomized controlled trial
-
Published:2023-12-11
Issue:1
Volume:23
Page:
-
ISSN:1471-2458
-
Container-title:BMC Public Health
-
language:en
-
Short-container-title:BMC Public Health
Author:
Fadaleh Sarah M. Abu,Pell Lisa G.,Yasin Muhammad,Farrar Daniel S.,Khan Sher Hafiz,Tanner Zachary,Paracha Shariq,Madhani Falak,Bassani Diego G.,Ahmed Imran,Soofi Sajid B.,Taljaard Monica,Spitzer Rachel F.,Bhutta Zulfiqar A.,Morris Shaun K.
Abstract
Abstract
Background
Ongoing high neonatal mortality rates (NMRs) represent a global challenge. In 2021, of the 5 million deaths reported worldwide for children under five years of age, 47% were newborns. Pakistan has one of the five highest national NMRs in the world, with an estimated 39 neonatal deaths per 1,000 live births. Reducing newborn deaths requires sustainable, evidence-based, and cost-effective interventions that can be integrated within existing community healthcare infrastructure across regions with high NMR.
Methods
This pragmatic, community-based, parallel-arm, open-label, cluster randomized controlled trial aims to estimate the effect of Lady Health Workers (LHWs) providing an integrated newborn care kit (iNCK) with educational instructions to pregnant women in their third trimester, compared to the local standard of care in Gilgit-Baltistan, Pakistan, on neonatal mortality and other newborn and maternal health outcomes. The iNCK contains a clean birth kit, 4% chlorhexidine topical gel, sunflower oil emollient, a ThermoSpot™ temperature monitoring sticker, a fleece blanket, a click-to-heat reusable warmer, three 200 μg misoprostol tablets, and a pictorial instruction guide and diary. LHWs are also provided with a handheld scale to weigh the newborn. The primary study outcome is neonatal mortality, defined as a newborn death in the first 28 days of life.
Discussion
This study will generate policy-relevant knowledge on the effectiveness of integrating evidence-based maternal and newborn interventions and delivering them directly to pregnant women via existing community health infrastructure, for reducing neonatal mortality and morbidity, in a remote, mountainous area with a high NMR.
Trial registration
NCT04798833, March 15, 2021.
Funder
Grand Challenges Canada Aga Khan Foundation Pakistan The Hospital for Sick Children
Publisher
Springer Science and Business Media LLC
Subject
Public Health, Environmental and Occupational Health
Reference30 articles.
1. United Nations Inter-agency Group for Child Mortality, E., Levels, and trends in child mortality: report 2022. 2022, UNICEF: New York, NY. Available at: [Accessed 17 May 2022]. 2. Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. Global, regional, and national causes of under-5 mortality in 2000–19: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet Child Adolesc Health. 2022;6(2):106–15. 3. Bhutta ZA, Das JK, Bahl R, Lawn JE, Salam RA, Paul VK, et al. Can available interventions end preventable deaths in mothers, newborn babies, and stillbirths, and at what cost? The Lancet. 2014;384(9940):347–70. 4. Aziz A, Saleem S, Nolen TL, Pradhan NA, Mcclure EM, Jessani S, et al. Why are the Pakistani maternal, fetal and newborn outcomes so poor compared to other low and middle-income countries? Reprod Health. 2020;17(S3):190. 5. International., N.I.o.P.S.N.P.a.I., Pakistan Demographic and Health Survey 2017- 2018. 2018: Islamabad, Pakistan, and Calverton, Maryland, USA: NIPS and ICF International.
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
|
|