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Effect of facilitat...
Effect of facilitation of local maternal-and-newborn stakeholder groups on neonatal mortality : cluster-randomized controlled trial
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- Persson, Lars-Åke, 1947- (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition/Persson
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- Nga, Nguyen Thu (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition/Persson
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- Målqvist, Mats, 1971- (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition/Persson
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- Thi Phuong Hoa, Dinh (author)
- Hanoi School of Public Health, Hanoi, Viet Nam
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- Eriksson, Leif (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition/Persson
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- Wallin, Lars (author)
- Karolinska Institutet,Högskolan Dalarna,Omvårdnad,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm
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- Selling, Katarina, 1976- (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition/Persson
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- Huy, Tran Q (author)
- Ministry of Health, Hanoi, Viet Nam
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Duc, Duong M (author)
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- Tiep, Tran V (author)
- Vietnam-Sweden Uong Bi General Hospital, Uong Bi, Viet Nam
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- Thi Thu Thuy, Vu (author)
- Provincial Health Bureau, Quang Ninh Province, Viet Nam
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- Ewald, Uwe, 1945- (author)
- Uppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Barnendokrinologisk forskning/Gustafsson
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(creator_code:org_t)
- 2013-05-14
- 2013
- English.
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In: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 10:5
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Abstract
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- BACKGROUND: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam.METHODS AND FINDINGS: In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]).CONCLUSIONS: A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period.TRIAL REGISTRATION: Current Controlled Trials ISRCTN44599712. Please see later in the article for the Editors' Summary.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
Keyword
- Hälsa och välfärd
- Health and Welfare
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Persson, Lars-Åk ...
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Nga, Nguyen Thu
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Målqvist, Mats, ...
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Thi Phuong Hoa, ...
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Eriksson, Leif
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Wallin, Lars
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Selling, Katarin ...
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Huy, Tran Q
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Duc, Duong M
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Tiep, Tran V
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Thi Thu Thuy, Vu
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Ewald, Uwe, 1945 ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Health Sciences
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and Nursing
- Articles in the publication
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PLoS Medicine
- By the university
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Högskolan Dalarna
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Uppsala University
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Karolinska Institutet