Neonatal Death, Preterm Birth, Preterm Labor
Conditions
Keywords
Facility delivery, Neonatal mortality, Preterm delivery, Preterm birth, Perinatal mortality
Brief summary
The purpose of this Quality Improvement initiative is to reduce severe morbidity and mortality among premature infants through proven and cost-effective clinical management during the antenatal, intrapartum, and postpartum periods. In order to reduce neonatal mortality and morbidity due to preterm birth complications, health facilities must be able to identify and manage women in preterm labor, accurately administer medications, and provide high-quality postnatal care.
Detailed description
The purpose of this Quality Improvement initiative is to reduce severe morbidity and mortality among premature infants through proven and cost-effective clinical management during the antenatal, intrapartum, and postpartum periods. In order to reduce neonatal mortality and morbidity due to preterm birth complications, health facilities must be able to identify and manage women in preterm labor, accurately administer medications, and provide high-quality postnatal care. The study will provide evidence of implementing a package of clinical interventions coupled with quality improvement and monitoring strategy aimed at reducing neonatal mortality in 3 resource-limited health facilities, leveraging on an existing strengthened birth registry to provide neonatal outcomes up to 28 days after delivery. Additionally, using a multifaceted approach through an interdisciplinary team, the investigators will identify the social and cultural barriers that contribute to home-based deliveries. These findings will be helpful to the Ministry of Health in shaping future policies regarding the scale-up of newborn care clinical protocols as part of Government's efforts to reducing neonatal mortality in Zambia.
Interventions
None listed
Sponsors
Centre for Infectious Disease Research in Zambia
University of Alabama at Birmingham
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
10 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Pregnant women who seek Antenatal care services and plan to deliver in the selected health facilities * Women who reside within the larger catchment area of the selected 3 health facilities
Exclusion criteria
* Women who reside outside the larger catchment area of the health facilities * Women who have not sought antenatal care services in the 3 health facilities and have come to only deliver there
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 10% relative risk reduction in 28-day neonatal mortality rate in preterm infants | Baseline to 36 months | Rate of 28-day neonatal mortality at the end of the study compared to that at baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| 20% relative risk reduction in all-cause 7-day neonatal mortality in preterm infants | Baseline to 36 months | Rate of 7-day neonatal mortality at the end of the study compared to that at baseline |
| Factors that contribute to home and facility deliveries within the PREEMI facility catchment areas through the use of pre-determined questionnaire. | Baseline to 36 months | Number of study participants who delivered at home and at a health facility |
Countries
Zambia
Outcome results
None listed