Institutionalising the community health system to reduce preventable neonatal deaths in rural Zimbabwe

Effect of institutionalising three community health system vital signs (village health workforce; community governance structures; modified women's and men's learning and action groups) on preventable neonatal deaths in Mashonaland West Province, Zimbabwe, 2020–2021: a two-arm parallel-group cluster randomised controlled trial

Status

Active, not recruiting

Phases

Unknown

Study type

Interventional

Source

PACTR

Registry ID

PACTR202607591142118

Enrollment

984

Registered

2026-07-07

Start date

2020-02-01

Completion date

Unknown

Last updated

2026-09-14

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Neonatal Diseases

Interventions

Institutionalised community health system package vital signs

Standard community health service delivery per Ministry of Health and Child Care policy

Eligibility

Sex/Gender

Female

Inclusion criteria

Inclusion criteria: Cluster level: All 211 wards in Mashonaland West Province were eligible. Fifty-two wards were randomly selected from the 211 eligible wards and randomised to the trial arms. Individual level: Women of childbearing age (15–49 years) who were permanent residents of an eligible ward.

Exclusion criteria

Exclusion criteria: Cluster level: Wards containing or served by a referral hospital were excluded, to minimise the confounding effect of tertiary-level care on neonatal outcomes, since referral hospitals provide a substantially different standard of obstetric and neonatal care from the primary health care clinics that are the focus of this intervention. Individual level: Visitors to the study area — individuals who were not permanent residents of the eligible wards at the time of the study — were excluded, to ensure outcome data reflected the resident population and to maintain the integrity of cluster boundaries.

Design outcomes

Primary

Measure	Time frame
Preventable neonatal deaths per 1,000 live births at 28 days of life (attributable to preterm birth complications and neonatal infections).	—

Secondary

Measure	Time frame
• Timely care-seeking for newborn danger signs (care within 24 hours of symptom onset). • Immediate newborn care practices (timely drying, skin-to-skin contact, early breastfeeding initiation), measured at 7 and 28 days. • Maternal health service uptake (=4 ANC visits, postnatal care attendance). • Functionality of community-level health committees. • Neonatal morbidity (incidence proportion of major morbidities such as sepsis, by clinical or verbal-autopsy criteria). • Contamination rate in control clusters. • Composite intervention fidelity score (mean Fi per cluster).	—

Measure

Time frame

• Timely care-seeking for newborn danger signs (care within 24 hours of symptom onset). • Immediate newborn care practices (timely drying, skin-to-skin contact, early breastfeeding initiation), measured at 7 and 28 days. • Maternal health service uptake (=4 ANC visits, postnatal care attendance). • Functionality of community-level health committees. • Neonatal morbidity (incidence proportion of major morbidities such as sepsis, by clinical or verbal-autopsy criteria). • Contamination rate in control clusters. • Composite intervention fidelity score (mean Fi per cluster).

—

Countries

Zimbabwe

Contacts

Public ContactEustackio Kazonga

University of Lusaka

ekazonga@yahoo.co.uk+260969220076

Outcome results

None listed

Source: PACTR (via WHO ICTRP) · Data processed: Sep 19, 2026