dc.contributor.author |
Rao, Sowmya R |
|
dc.contributor.author |
Simmons, Elizabeth M. |
|
dc.contributor.author |
Moore, Janet |
|
dc.contributor.author |
Goldenberg, Robert L. |
|
dc.contributor.author |
Gouda, Shivaprasad S |
|
dc.contributor.author |
Esamai, Fabian |
|
dc.contributor.author |
Nyongesa, Paul |
|
dc.contributor.author |
Garces, Ana L. |
|
dc.contributor.author |
Chomba, Elwyn |
|
dc.contributor.author |
Mwenechanya, Musaku |
|
dc.contributor.author |
Bauserman, Melissa |
|
dc.contributor.author |
Bucher, Sherri |
|
dc.contributor.author |
Krebs, Nancy F |
|
dc.contributor.author |
Carlo, Waldemar A |
|
dc.contributor.author |
Koso‑ThomasMcClure, Marion Elizabeth M |
|
dc.contributor.author |
Saleem, Sarah |
|
dc.contributor.author |
Hibberd, Patricia L. |
|
dc.contributor.author |
Patel, Archana B. |
|
dc.contributor.author |
Nolen, Tracy L. |
|
dc.contributor.author |
Somannavar, Manjunath S. |
|
dc.contributor.author |
Naqvi, Farnaz |
|
dc.contributor.author |
Derman, Richard J. |
|
dc.date.accessioned |
2022-09-19T13:37:04Z |
|
dc.date.available |
2022-09-19T13:37:04Z |
|
dc.date.issued |
2020-11-30 |
|
dc.identifier.uri |
https://doi.org/10.1186/s12978-020-01010-w |
|
dc.identifier.uri |
http://ir.mu.ac.ke:8080/jspui/handle/123456789/6689 |
|
dc.description.abstract |
Background: Neonatal deaths in first 28‑days of life represent 47% of all deaths under the age of five years globally
and are a focus of the United Nation’s (UN’s) Sustainable Development Goals. Pregnant women are delivering in facili‑
ties but that does not indicate quality of care during delivery and the postpartum period. The World Health Organiza‑
tion’s Essential Newborn Care (ENC) package reduces neonatal mortality, but lacks a simple and valid composite index
that measures its effectiveness.
Methods: Data on 5 intra‑partum and 3 post‑partum practices (indicators) recommended as part of ENC, routinely
collected in NICHD’s Global Network’s (GN) Maternal Newborn Health Registry (MNHR) between 2010 and 2013, were
included. We evaluated if all 8 practices (Care around Delivery – CAD), combined as an index was associated with
reduced early neonatal mortality rates (days 0–6 of life).
Results: A total of 150,848 live births were included in the analysis. The individual indicators varied across sites. All
components were present in 19.9% births (range 0.4 to 31% across sites). Present indicators (8 components) were
associated with reduced early neonatal mortality [adjusted RR (95% CI):0.81 (0.77, 0.85); p < 0.0001]. Despite an overall
association between CAD and early neonatal mortality (RR < 1.0 for all early mortality): delivery by skilled birth atten‑
dant; presence of fetal heart and delayed bathing were associated with increased early neonatal mortality.
Conclusions: Present indicators (8 practices) of CAD were associated with a 19% reduction in the risk of neonatal
death in the diverse health facilities where delivery occurred within the GN MNHR. These indicators could be moni
tored to identify facilities that need to improve compliance with ENC practices to reduce preventable neonatal
deaths. Three of the 8 indicators were associated with increased neonatal mortality, due to baby being sick at birth. |
en_US |
dc.description.sponsorship |
Eunice Kennedy Shriver |
en_US |
dc.language.iso |
en |
en_US |
dc.publisher |
Biomed central |
en_US |
dc.subject |
Neonatal mortality |
en_US |
dc.subject |
Early neonatal mortality |
en_US |
dc.subject |
Quality of care |
en_US |
dc.subject |
Labor and delivery care |
en_US |
dc.subject |
Newborn care |
en_US |
dc.subject |
Composite index |
en_US |
dc.subject |
Intrapartum care |
en_US |
dc.subject |
Postpartum care |
en_US |
dc.subject |
Early neonatal period |
en_US |
dc.subject |
Low income countries |
en_US |
dc.subject |
Low and middle income countries |
en_US |
dc.subject |
Essential newborn care |
en_US |
dc.subject |
Global network |
en_US |
dc.title |
Evaluating the effect of care around labor and delivery practices on early neonatal mortality in the global network’s maternal and newborn health registry |
en_US |
dc.type |
Article |
en_US |