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Sökning: WFRF:(Jackson Debra) > (2010-2014) > An effectiveness st...

  • Tomlinson, MarkDepartment of Psychology, Stellenbosch University, Matieland, South Africa (författare)

An effectiveness study of an integrated, community-based package for maternal, newborn, child and HIV care in South Africa : study protocol for a randomized controlled trial

  • Artikel/kapitelEngelska2011

Förlag, utgivningsår, omfång ...

  • 2011-11-01
  • Springer Science and Business Media LLC,2011
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:uu-161792
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-161792URI
  • https://doi.org/10.1186/1745-6215-12-236DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: Progress towards MDG4 in South Africa will depend largely on scaling up effective prevention against mother to child transmission (PMTCT) of HIV and also addressing neonatal mortality. This imperative drives increasing focus on the neonatal period and particularly on the development and testing of appropriate models of sustainable, community-based care in South Africa in order to reach the poor. A number of key implementation gaps affecting progress have been identified. Implementation gaps for HIV prevention in neonates; implementation gaps for neonatal care especially home postnatal care; and implementation gap for maternal mental health support. We have developed and are evaluating and costing an integrated and scaleable home visit package delivered by community health workers targeting pregnant and postnatal women and their newborns to provide essential maternal/newborn care as well as interventions for Prevention of Mother to Child Transmission (PMTCT) of HIV.METHODS:The trial is a cluster randomized controlled trial that is being implemented in Umlazi which is a peri-urban settlement with a total population of 1 million close to Durban in KwaZulu Natal, South Africa. The trial consists of 30 randomized clusters (15 in each arm). A baseline survey established the homogeneity of clusters and neither stratification nor matching was performed. Sample size was based on increasing HIV-free survival from 74% to 84%, and calculated to be 120 pregnant women per cluster. Primary outcome is higher levels of HIV free survival and levels of exclusive and appropriate infant feeding at 12 weeks postnatally. The intervention is home based with community health workers deliver two antenatal visits, a postnatal visit within 48 hours of birth, and a further four visits during the first two months of the infants life. We are undertaking programmatic and cost effectiveness analysis to cost the intervention.DISCUSSION:The question is not merely to develop an efficacious package but also to identify and test delivery strategies that enable scaling up, which requires effectiveness studies in a health systems context, adapting and testing Asian community-based studies in various African contexts.

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Doherty, TanyaSchool of Public Health, University of the Western Cape, Cape Town, South Africa (författare)
  • Jackson, DebraSchool of Public Health, University of the Western Cape, Cape Town, South Africa (författare)
  • Lawn, JoySaving Newborn Lives, Cape Town, South Africa (författare)
  • Ijumba, PetridaHealth Systems Research Unit, Medical Research Council, Tygerberg, South Africa (författare)
  • Colvin, MarkMaromi Health Research, Glenwood, South Africa (författare)
  • Nkonki, LungiswaHealth Systems Research Unit, Medical Research Council, Tygerberg, South Africa (författare)
  • Daviaud, EmmanuelleHealth Systems Research Unit, Medical Research Council, Tygerberg, South Africa (författare)
  • Goga, AmeenaHealth Systems Research Unit, Medical Research Council, Tygerberg, South Africa (författare)
  • Sanders, DavidSchool of Public Health, University of the Western Cape, Cape Town, South Africa (författare)
  • Lombard, CarlBiostatistics, Medical Research Council, Tygerberg, South Africa (författare)
  • Persson, Lars-ÅkeUppsala universitet,Internationell mödra- och barnhälsovård (IMCH),Internationell barnhälsa och nutrition/Persson(Swepub:uu)laper499 (författare)
  • Ndaba, ThokoHealth Systems Research Unit, Medical Research Council, Tygerberg, South Africa (författare)
  • Snetro, GailSaving Newborn Lives, Cape Town, South Africa (författare)
  • Chopra, MickeyChief of Health, UNICEF, New York, USA (författare)
  • Department of Psychology, Stellenbosch University, Matieland, South AfricaSchool of Public Health, University of the Western Cape, Cape Town, South Africa (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Trials: Springer Science and Business Media LLC12:1, s. 236-1745-6215

Internetlänk

Hitta via bibliotek

  • Trials (Sök värdpublikationen i LIBRIS)

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