Infection, Sepsis, Umbilical Cord
Conditions
Keywords
Perinatal, Handwashing, Neonatal, Morbidity, Mortality, Primiparous, Health behavior, Developing countries, Sepsis, Omphalitis, Infectious disease, Bangladesh
Brief summary
The purpose of this study is to determine if an intensive handwashing intervention administered to primiparous women during their pregnancy can increase maternal handwashing with soap at critical times.
Detailed description
In high neonatal mortality settings, about half of neonatal deaths are estimated to occur because of infectious syndromes such as sepsis, acute respiratory infection, neonatal tetanus, and diarrhea. Promoting handwashing to mothers in the post-neonatal period has been shown to reduce the risk of pneumonia and diarrhea among infants \> 28 days old but there is little information on the protective effect of handwashing for neonatal health outcomes. The proposed study will assess motivators and barriers to handwashing with soap among new mothers, and develop and test a hand cleansing promotion intervention in rural Bangladesh. The handwashing behavior change intervention will include approaches to enhance maternal expectations of being a good nurturer, as well as enhancing maternal self-efficacy to carry out handwashing behavior.
Interventions
BEHAVIORALPerinatal Handwashing Promotion
Pregnancy may serve as a unique opportunity to improve maternal handwashing behavior more deeply and sustainably than a handwashing promotion intervention at a different time. Primiparous women will receive an intensive handwashing promotion program delivered at 3 in-home visits between one month prenatal and 1 week post natal. The program will promote handwashing benefits, provide hardware to reduce barriers to handwashing, and educate mothers about the critical times for handwashing. Mothers will also receive an essential neonatal care package with information on clean delivery, hypothermia prevention, breastfeeding counseling, umbilical cord care, and identification of neonatal danger signs.
BEHAVIORALNeonatal Health Promotion
Mothers will receive an essential neonatal care package with information on clean delivery, hypothermia prevention, breastfeeding counseling, umbilical cord care, and identification of neonatal danger signs.
Sponsors
State University of New York at Buffalo
Centers for Disease Control and Prevention
International Centre for Diarrhoeal Disease Research, Bangladesh
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
No
Inclusion criteria
* Primiparous women who plan to remain in the study area up to 1 months after birth
Exclusion criteria
* Prior live birth
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Proportion of critical events where neonatal caregivers wash their hands with soap as a measure of behavior change. | 1 month post-natal |
| Daily reduction in household soap weight. | 2 weeks post-natal. |
Secondary
| Measure | Time frame |
|---|---|
| Incidence density of suspected sepsis in neonates | 1 month post natal |
| Incidence density of suspected omphalitis in neonates | 1 month post-natal |
| All cause neonatal mortality rate. | 1 month post-natal. |
Countries
Bangladesh
Outcome results
None listed