Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trial

Vishwajeet Kumar, Saroj Mohanty, Aarti Kumar, Rajendra P. Misra, Mathuram Santosham, Shally Awasthi, Abdullah Baqui, Pramod Singh, Vivek Singh, Ramesh C. Ahuja, Jai Vir Singh, Gyanendra Kumar Malik, Saifuddin Ahmed, Robert E Black, Mahendra Bhandari, Gary L. Darmstadt

Research output: Contribution to journalArticle

Abstract

Background: In rural India, most births take place in the home, where high-risk care practices are common. We developed an intervention of behaviour change management, with a focus on prevention of hypothermia, aimed at modifying practices and reducing neonatal mortality. Methods: We did a cluster-randomised controlled efficacy trial in Shivgarh, a rural area in Uttar Pradesh. 39 village administrative units (population 104 123) were allocated to one of three groups: a control group, which received the usual services of governmental and non-governmental organisations in the area; an intervention group, which received a preventive package of interventions for essential newborn care (birth preparedness, clean delivery and cord care, thermal care [including skin-to-skin care], breastfeeding promotion, and danger sign recognition); or another intervention group, which received the package of essential newborn care plus use of a liquid crystal hypothermia indicator (ThermoSpot). In the intervention clusters, community health workers delivered the packages via collective meetings and two antenatal and two postnatal household visitations. Outcome measures included changes in newborn-care practices and neonatal mortality rate compared with the control group. Analysis was by intention to treat. This study is registered as International Standard Randomised Control Trial, number NCT00198653. Findings: Improvements in birth preparedness, hygienic delivery, thermal care (including skin-to-skin care), umbilical cord care, skin care, and breastfeeding were seen in intervention arms. There was little change in care-seeking. Compared with controls, neonatal mortality rate was reduced by 54% in the essential newborn-care intervention (rate ratio 0·46 [95% CI 0·35-0·60], p

Original languageEnglish (US)
Pages (from-to)1151-1162
Number of pages12
JournalThe Lancet
Volume372
Issue number9644
DOIs
StatePublished - 2008

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Skin Care
Infant Mortality
India
Randomized Controlled Trials
Newborn Infant
Parturition
Breast Feeding
Hypothermia
Hot Temperature
Liquid Crystals
Control Groups
Intention to Treat Analysis
Mortality
Umbilical Cord
Outcome Assessment (Health Care)
Organizations
Population

ASJC Scopus subject areas

  • Medicine(all)

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Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India : a cluster-randomised controlled trial. / Kumar, Vishwajeet; Mohanty, Saroj; Kumar, Aarti; Misra, Rajendra P.; Santosham, Mathuram; Awasthi, Shally; Baqui, Abdullah; Singh, Pramod; Singh, Vivek; Ahuja, Ramesh C.; Singh, Jai Vir; Malik, Gyanendra Kumar; Ahmed, Saifuddin; Black, Robert E; Bhandari, Mahendra; Darmstadt, Gary L.

In: The Lancet, Vol. 372, No. 9644, 2008, p. 1151-1162.

Research output: Contribution to journalArticle

Kumar, V, Mohanty, S, Kumar, A, Misra, RP, Santosham, M, Awasthi, S, Baqui, A, Singh, P, Singh, V, Ahuja, RC, Singh, JV, Malik, GK, Ahmed, S, Black, RE, Bhandari, M & Darmstadt, GL 2008, 'Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India: a cluster-randomised controlled trial', The Lancet, vol. 372, no. 9644, pp. 1151-1162. https://doi.org/10.1016/S0140-6736(08)61483-X
Kumar, Vishwajeet ; Mohanty, Saroj ; Kumar, Aarti ; Misra, Rajendra P. ; Santosham, Mathuram ; Awasthi, Shally ; Baqui, Abdullah ; Singh, Pramod ; Singh, Vivek ; Ahuja, Ramesh C. ; Singh, Jai Vir ; Malik, Gyanendra Kumar ; Ahmed, Saifuddin ; Black, Robert E ; Bhandari, Mahendra ; Darmstadt, Gary L. / Effect of community-based behaviour change management on neonatal mortality in Shivgarh, Uttar Pradesh, India : a cluster-randomised controlled trial. In: The Lancet. 2008 ; Vol. 372, No. 9644. pp. 1151-1162.
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abstract = "Background: In rural India, most births take place in the home, where high-risk care practices are common. We developed an intervention of behaviour change management, with a focus on prevention of hypothermia, aimed at modifying practices and reducing neonatal mortality. Methods: We did a cluster-randomised controlled efficacy trial in Shivgarh, a rural area in Uttar Pradesh. 39 village administrative units (population 104 123) were allocated to one of three groups: a control group, which received the usual services of governmental and non-governmental organisations in the area; an intervention group, which received a preventive package of interventions for essential newborn care (birth preparedness, clean delivery and cord care, thermal care [including skin-to-skin care], breastfeeding promotion, and danger sign recognition); or another intervention group, which received the package of essential newborn care plus use of a liquid crystal hypothermia indicator (ThermoSpot). In the intervention clusters, community health workers delivered the packages via collective meetings and two antenatal and two postnatal household visitations. Outcome measures included changes in newborn-care practices and neonatal mortality rate compared with the control group. Analysis was by intention to treat. This study is registered as International Standard Randomised Control Trial, number NCT00198653. Findings: Improvements in birth preparedness, hygienic delivery, thermal care (including skin-to-skin care), umbilical cord care, skin care, and breastfeeding were seen in intervention arms. There was little change in care-seeking. Compared with controls, neonatal mortality rate was reduced by 54{\%} in the essential newborn-care intervention (rate ratio 0·46 [95{\%} CI 0·35-0·60], p",
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T2 - a cluster-randomised controlled trial

AU - Kumar, Vishwajeet

AU - Mohanty, Saroj

AU - Kumar, Aarti

AU - Misra, Rajendra P.

AU - Santosham, Mathuram

AU - Awasthi, Shally

AU - Baqui, Abdullah

AU - Singh, Pramod

AU - Singh, Vivek

AU - Ahuja, Ramesh C.

AU - Singh, Jai Vir

AU - Malik, Gyanendra Kumar

AU - Ahmed, Saifuddin

AU - Black, Robert E

AU - Bhandari, Mahendra

AU - Darmstadt, Gary L.

PY - 2008

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