Low Birthweight, Neonatal Death, Neonatal Hypoglycemia, Preterm Birth
Conditions
Keywords
Facility births
Brief summary
Universal coverage of good quality facility based care globally could prevent nearly 113,000 maternal deaths, 531,000 stillbirths and 1.3 million neonatal deaths annually by 2020. Yet, only 57% of pregnant Ugandan women choose to deliver at health facilities. This unacceptably low coverage of facility based births could explain, in part, the high maternal and perinatal mortality estimates in Uganda. While multiple studies have examined factors associated with this low utilization of health services around the time of birth, there is inadequate implementation research exploring the best systematic methods that could promote uptake and scale up of facility based births. This study will therefore examine the effect of an intervention package (peer counselling by pregnancy buddies on facility based births, mobile phone messaging promoting facility based births and provision of mama-kits) on the frequency of facility based births and perinatal mortality. The study, a cluster randomized community based intervention trial in post-conflict Northern Uganda, will provide data crucial in framing national policy regarding measures to promote the use of health facilities.
Interventions
BEHAVIORALIntervention arm: An integrated package
See description in previous column
Sponsors
Centre For International Health
Makerere University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Healthy volunteers
Yes
Inclusion criteria
* Pregnant women at 28 or more weeks of gestation * Residence in the selected clusters * Pregnant women under 18 years of age will be included since they are considered as emancipated minors in Uganda
Exclusion criteria
* Intention to move from the study area within one year * Psychiatric ailments that may inhibit the informed consent process
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Facility based birth | Day 1 | Delivery at a health facility |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timely initiation of breastfeeding | Up-to one hour after birth | Initiation of breastfeeding with the first hour after birth |
| Severe illness | Day 28 | Severe illness within the first month of life |
| The percent of newborns attended by a health care pro-vider during the first 48 hours following birth | Up-to 48 hours after birth | Proportion of babies seen by a health care work in the first 48 hours after birth |
| The percent of newborns attended by a health care pro-vider during the first 7 days following birth | 1 week | Proportion of babies seen by a health care work in the first one week after birth |
| Neonatal death | Day 28 | Death within the first month of life |
Other
| Measure | Time frame | Description |
|---|---|---|
| Neonatal hypoglycemia | Up-to 7 days after birth | Proportion of infants with random blood glucose less than 47mg/dl |
| Preterm birth | 7 days postpartum | Proportion of infants born at less than 37 completed weeks of gestation measured by the New Ballad Score |
| Low birthweight | Up-to 48 hours after birth | Proportion of infants with a birthweight =\< 2500gms |
Countries
Uganda
Outcome results
None listed