Bulletin of the World Health Organization

Impact of an integrated nutrition and health programme on neonatal mortality in rural northern India

Abdullah H Baqui, Emma K Williams, Amanda M Rosecrans, Praween K Agrawal, Saifuddin Ahmed, Gary L Darmstadt, Vishwajeet Kumar, Usha Kiran, Dharmendra Panwar, Ramesh C Ahuja, Vinod K Srivastava, Robert E Black, Manthuram Santosham

Volume 86, Number 10, October 2008, 796-804

Table 3. Programme exposure and behaviour change in recently delivered women by study district: baseline (2001–2002) and endline (2004–2005)

Indicator Number of recently delivered women (%)
Baseline survey
Endline survey
AdjustedP-valuea
Comparison district(n = 6 196) Intervention district(n = 8 756) Comparison district(n = 6 014) Intervention district(n = 7 812)
Exposure to intervention
Home visits < 0.001b
No visit 4623 (74.6) 7249 (82.8) 4673 (77.7) 2995 (38.3)
Only antenatal visit 1241 (20.0) 1212 (13.9) 1010 (16.8) 1747 (22.4)
Only postnatal visit within 28 days 123 (2.0) 116 (1.3) 91 (1.5) 450 (5.8)
Antenatal visit and postnatal visit:
within 28 days 209 (3.4) 179 (2.0) 240 (4.0) 2620 (33.5)
within 3 days 99 (1.6) 79 (0.9) 119 (2.0) 1585 (20.3) < 0.001
within 7 days 129 (2.1) 111 (1.2) 149 (2.5) 2025 (25.9) < 0.001

Behaviour change
Antenatal care
Proportion of mothers who:
Received ≥ 1 antenatal check-upc 1517 (24.5) 1451 (16.6) 1653 (27.5) 2771 (35.5) < 0.001
Received ≥ 3 antenatal check-upsc 426 (6.9) 316 (3.6) 538 (9.0) 952 (12.2) < 0.001
Received ≥ 2 tetanus immunizations 3590 (57.9) 4189 (47.8) 3764 (62.6) 5495 (70.3) < 0.001
Consumed ≥ 100 iron-folic acid tablets 412 (6.7) 436 (5.0) 497 (8.3) 1663 (21.3) < 0.001
Saved money for childbirth 758 (12.2) 1294 (14.8) 1795 (29.9) 3936 (50.4) < 0.001
Took any other birth planning stepd 1232 (19.9) 933 (10.7) 1082 (18.0) 2707 (34.6) < 0.001
Delivery and newborn care
Proportion of mothers who:
Delivered in a health facility or at home with a skilled birth attendantc 1085 (17.5) 1423 (16.3) 1314 (21.8) 1756 (22.5) < 0.009
Practiced clean cord caree 1992 (36.0) 2471 (32.1) 2117 (41.5) 4488 (68.4) < 0.001
Practiced newborn thermal care at least for first 6 hoursf 47 (0.8) 341 (3.9) 38 (0.6) 1900 (24.3) < 0.001
Initiated breastfeeding in first hour 148 (2.4) 268 (3.1) 347 (5.8) 2948 (37.7) < 0.001
Newborn check-up:c
within 3 days 263 (4.2) 101 (1.2) 483 (8.0) 1297 (16.6) < 0.001
within 7 days 383 (6.2) 152 (1.7) 552 (9.2) 1529 (19.6) < 0.001
within 28 days 571 (9.2) 209 (2.4) 712 (11.8) 1887 (24.2) < 0.001

a P-value for difference-in-difference test adjusted for age, education, parity, religion and standard-of-living score.b For change in coverage of all home visits (i.e. postnatal and antenatal) from baseline to endline (comparison group versus intervention group).c From a medically qualified doctor, nurse, lady health visitor or auxiliary nurse-midwife; newborn check-up includes care sought for sick babies and well baby care.d At least one of the following: suitable location for delivery, person to deliver baby, hospital/clinic to be attended in case of complication, arrangement for transport and disposable delivery kit.e Umbilical cord cut with boiled blade and tied with sterile thread.f Neonate dried and wrapped immediately after delivery and first bath delayed for at least 6 hours.

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