Home visits by community health workers to prevent neonatal deaths in developing countries: a systematic review
Siddhartha Gogia & Harshpal Singh Sachdev
Volume 88, Number 9, September 2010, 658-666B
Table 2. Characteristics of studies found through systematic review of trials of home-based interventions to reduce neonatal and infant deaths and stillbirths
| Author and year | Sylhet 2008 |
Hala 2008 |
Shivgarh 2008 |
Barabanki 2008 |
Gadhchiroli 2005 |
|---|---|---|---|---|---|
| Country | Bangladesh | Pakistan | India | India | India |
| Trial duration | 2.5 years | 2 years | 16 months | 2 years | 10 years |
| Randomization | Adequate | No | Adequate | Quasi-randomized | No |
| Allocation concealment | No | No | No | No | No |
| Adjustment for cluster analysis | Yes | NA | Yes | No | NA |
| Intention to treat analysis | Yes | Unknown | Yes | Yes | Yes |
| Health worker type | Female community health workers | Lady health workers | Community-based health workers (saksham sahayak) | Anganwadi workers, auxiliary nurse–midwives and “change agents” |
Village health workers |
| Training | 6 weeks training BCM, ENC and management of sick neonates |
6 months training BCM, ENC 3-day voluntary training programme for traditional birth attendants (dais) in basic newborn care |
7 days training BCM, ENC Community volunteers (saksham karta) helped community health workers (saksham sahayaks) |
6 days training ENC |
6 days training ENC |
| Intervention | |||||
| Maternal | Promotion of birth and neonatal care preparedness | Promotion of birth and neonatal care preparedness | Promotion of birth and neonatal care preparedness | Promotion of birth and neonatal care preparedness | Promotion of birth and neonatal care preparedness |
| Neonatal | ENC promotion Breastfeeding counselling Assessment and referral of sick neonates Domiciliary treatment with injectable antibiotics, if referral failed |
ENC promotion Breastfeeding counselling Assessment and referral of sick neonates Domiciliary treatment of neonatal pneumonia with oral cotrimoxazole |
ENC promotion Breastfeeding counselling Assessment and referral of sick neonates |
ENC promotion Breastfeeding counselling Assessment and referral of sick neonates |
ENC promotion Breastfeeding counselling Care at birth including neonatal resuscitation Assessment and referral of sick neonates Domiciliary treatment of neonatal sepsis with co-trimoxazole and gentamicin |
| Other (in experimental group) | 2-day training for TBAs | Community health committees for maternal and neonatal care Establishment of an emergency transport fund for mothers and neonates |
|||
| No. of home visits | 5 (2 during pregnancy, 1 within 24 hours of birth, and 1 on days 3 and 7 after delivery) | 7 (2 during pregnancy, 1 within 24 hours of birth, and 1 on days 3, 7, 14 and 28 after delivery) | 4 (2 during pregnancy, 1 within 24 hours of birth and 1 on day 3 after delivery) | 2 (1 during pregnancy and 1 within 28 days of delivery) | 13 (2 during pregnancy, 1 during delivery and 8–12 during neonatal period) |
| Vital events at end-line survey (intervention/control group) | |||||
| No. of live births | 2812/2872 | 2932/2610 | 2609/1079 | 7812/6014 | 1510/1676 |
| No. of neonatal deaths | 82/125 | 121/156 | 112/91 | 393/299 | 38/108 |
| No. of infant deaths | NA/NA | NA/NA | NA/NA | NA/NA | 47/127 |
| No. of stillbirths | NA/NA | 132/168 | 107/64 | NA/NA | 53/72 |
| Baseline neonatal mortality (deaths per 1 000 live births) | 48.0 | 52.1 | 84.2 | 45.8 | 65.2 |
BCM, behaviour change management; ENC, essential neonatal care; NA, not available; TBA, traditional birth attendant.