Abstract:
Background: Identifying every pregnancy, regardless of home or health facility delivery, is crucial to accurately
estimating maternal and neonatal mortality. Furthermore, obtaining birth weights and other anthropometric
measurements in rural settings in resource limited countries is a difficult challenge. Unfortunately for the majority
of infants born outside of a health care facility, pregnancies are often not recorded and birth weights are not
accurately known. Data from the initial 6 months of the Maternal and Neonatal Health (MNH) Registry Study of the
Global Network for Women and Children’s Health study area in Kenya revealed that up to 70% of newborns did
not have exact weights measured and recorded by the end of the first week of life; nearly all of these infants were
born outside health facilities.
Methods: To more completely obtain accurate birth weights for all infants, regardless of delivery site, village elders
were engaged to assist in case finding for pregnancies and births. All elders were provided with weighing scales
and mobile phones as tools to assist in subject enrollment and data recording. Subjects were instructed to bring
the newborn infant to the home of the elder as soon as possible after birth for weight measurement.
The proportion of pregnancies identified before delivery and the proportion of births with weights measured were
compared before and after provision of weighing scales and mobile phones to village elders. Primary outcomes
were the percent of infants with a measured birth weight (recorded within 7 days of birth) and the percent of
women enrolled before delivery.
Results: The recorded birth weight increased from 43 ± 5.7% to 97 ± 1.1. The birth weight distributions between
infants born and weighed in a health facility and those born at home and weighed by village elders were similar.
In addition, a significant increase in the percent of subjects enrolled before delivery was found.
Conclusions: Pregnancy case finding and acquisition of birth weight information can be successfully shifted to the
community level.