Rural community-based maternal and newborn interventions on prevention of neonatal morality

In this chapter we aimed to examine the effect of a community-based maternal and newborn interventions which include mother’s knowledge of pregnancy, delivery, postpartum and newborn complications, care seeking behaviour and newborn health practices on neonatal mortality in rural Uttar Pradesh, India. Data came from a household survey conducted to evaluate a community-based maternal and newborn intervention program in two districts of Uttar Pradesh, India. Analysis included data from 13,612 recently delivered women who had a singleton live birth during 2004-2005 at home. Neonatal mortality was 23% lower among mothers who had better knowledge of pregnancy and delivery related complications (OR:0.77; 95% CI:0.57-1.04;p = 0.090) than who had a poor knowledge; almost half among mothers who fed colostrums to their newborn(OR:0.54; 95% CI:0.40-0.73; p < 0.0001), who provided complete thermal care (OR:0.65; 95% CI:0.50-0.84; p = 0.0001), among mothers who received two or more doses of TT injections (OR:0.80; 95% CI:0.62-1.04) and among the newborns whose mother attained high school and above education (OR:0.56 ;95% CI:0.37-0.86; p < 0.0001) than their counterparts. However, the likelihood of neonatal mortality was almost twice (OR:1.87; 95% CI:1.33-2.61;p < 0.0001) among the newborn whose birth interval was less than 18 months. Our study suggests that most of the neonatal deaths in rural India can be preventable if mothers have better knowledge of pregnancy and delivery related complications, and had ‘preventive’ rather than ‘curative’ newborn health care practices at the community level. Intervention program should focus more on the spacing methods for optimum birth interval, colostrum feeding along with improving mother’s knowledge of complications.