Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India.
Background: Neonatal care is not available to most neonates in developing countries because hospitals are inaccessible and costly. We developed a package of home-based neonatal care, including management of sepsis (septicaemia, meningitis, pneumonia), and tested it in the field, with the hypothesis...
| Publicado en: | Lancet Vol. 354; no. 9194; pp. 1955 - 1962 |
|---|---|
| Autores principales: | , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lancet
12/4/1999
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107092453&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107092453 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01406736 LAN jtl: Lancet issn: 01406736 maglogo: N pubinfo: dt: 12/4/1999 vid: 354 iid: 9194 pid: 1297 pub: Lancet place: Philadelphia, Pennsylvania artinfo: ui: 107092453 107092453 NLM10622298 2000018736 10.1016/s0140-6736(99)03046-9 NLM10622298 107092453 ppf: 1955 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. aug: au: Bang AT Bang RA Baitule SB Reddy MH Deshmukh MD Bang, A T Bang, R A Baitule, S B Reddy, M H Deshmukh, M D affil: Society for Education, Action, and Research in Community Health, Gadchiroli, Maharashtra, India sug: subj: Infant Mortality Home Health Care In Infancy and Childhood Infant Care Infant, Newborn, Diseases Therapy Infant, Newborn Neonatal Sepsis Therapy Asphyxia Neonatorum Therapy Data Analysis, Statistical Home Health Care Economics Infant, Premature Experimental Studies Funding Source Health Education India Community Health Workers Rural Areas Human Infant, Newborn: birth-1 month ab: Background: Neonatal care is not available to most neonates in developing countries because hospitals are inaccessible and costly. We developed a package of home-based neonatal care, including management of sepsis (septicaemia, meningitis, pneumonia), and tested it in the field, with the hypothesis that it would reduce the neonatal mortality rate by at least 25% in 3 years.Methods: We chose 39 intervention and 47 control villages in the Gadchiroli district in India, collected baseline data for 2 years (1993-95), and then introduced neonatal care in the intervention villages (1995-98). Village health workers trained in neonatal care made home visits and managed birth asphyxia, premature birth or low birthweight, hypothermia, and breast-feeding problems. They diagnosed and treated neonatal sepsis. Assistance by trained traditional birth attendants, health education, and fortnightly supervisory visits were also provided. Other workers recorded all births and deaths in the intervention and the control area (1993-98) to estimate mortality rates.Findings: Population characteristics in the intervention and control areas, and the baseline mortality rates (1993-95) were similar. Baseline (1993-95) neonatal mortality rate in the intervention and the control areas was 62 and 58 per 1000 live births, respectively. In the third year of intervention 93% of neonates received home-based care. Neonatal, infant, and perinatal mortality rates in the intervention area (net percentage reduction) compared with the control area, were 25.5 (62.2%), 38.8 (45.7%), and 47.8 (71.0%), respectively (p<0.001). Case fatality in neonatal sepsis declined from 16.6% (163 cases) before treatment, to 2.8% (71 cases) after treatment by village health workers (p<0.01). Home-based neonatal care cost US$5.3 per neonate, and in 1997-98 such care averted one death (fetal or neonatal) per 18 neonates cared for.Interpretation: Home-based neonatal care, including management of sepsis, is acceptable, feasible, and reduced neonatal and infant mortality by nearly 50% among our malnourished, illiterate, rural study population. Our approach could reduce neonatal mortality substantially in developing countries. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|