Quality of care for small and sick neonates Other
Conditions
Interventions
The study hospitals all participate in NEST360 – they receive a bundle of inputs and activities that include: the provision of affordable technologies to keep babies warm, help them breath, treat jaun
the training of technicians and clinicians
enhanced data systems
and support for regular quality improvement visits.
Participating hospitals in the trial are randomly allocated to one of two groups.
Hospitals are assigned to intervention or control in a ratio of
2. Monitoring the adoption of management practices
Sponsors
London School of Hygiene & Tropical Medicine
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Hospitals: 1. Part of the NEST360 network of hospitals in Malawi 2. More than 3,000 births per year 3. Government-owned hospital or Christian Health Association of Malawi (CHAM) hospital Patients: 1. Baby admitted to the neonatal unit of a study hospital 2. Baby alive at admission to the neonatal unit
Exclusion criteria
Exclusion criteria: Hospitals: 1. Central level hospitals Patients: 1. Birthweight of baby is 1000g or less
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| All-cause in-hospital mortality of patients admitted to the neonatal unit of the study hospitals, measured over a 6-month period 9-15 months after the start of the management intervention using the Neonatal Inpatient Dataset, an electronic medical records information system. | — |
Secondary
| Measure | Time frame |
|---|---|
| Current secondary outcome measures as of 12/09/2024: 1. All cause in-hospital mortality over each of the third, fourth and fifth quarter-years of follow-up to track if the effect on mortality changes over time 2. All cause in-hospital mortality in each birthweight category (1001g-1500g, 1501g-2000g, 2001g-2500g, 2501g+), measured between month 9 and month 15 after the start of the management intervention 3. Proportion of newborns receiving pulse oximetry at admission, measured between month 9 and month 15 after the start of the management intervention 4. Proportion of newborns with their temperature taken at admission, measured between month 9 and month 15 after the start of the management intervention 5. Proportion of newborns with a glucose test taken at admission, measured between month 9 and month 15 after the start of the management intervention 6. Proportion of newborns that has all three diagnostics at admission assessment (pulse oximetry, temperature taken, glucose test completed), measured between month 9 and month 15 after the start of the management intervention 7. Proportion of newborns exclusively breastfed on discharge from the neonatal unit, measured between month 9 and month 15 after the start of the management intervention 8. Proportion of newborns with birthweight 1000g-1499g or those with birthweight 1500g-1999g and respiratory distress syndrome and hypoxia receiving Continuous Positive Airway Pressure (CPAP) during admission to neonatal unit, measured between month 9 and month 15 after the start of the management intervention 9. Proportion of newborns with clinical sepsis diagnosis given antibiotics during admission to neonatal unit, measured between month 9 and month 15 after the start of the management intervention 10. Proportion of newborns with clinical sepsis diagnosis that have a blood culture done, measured between month 9 and month 15 after the start of the management intervention 11. Proportion of newborns that have a blood culture | — |
Countries
Malawi
Outcome results
None listed