The Experts below are selected from a list of 1527 Experts worldwide ranked by ideXlab platform
Zulfiqar A Bhutta - One of the best experts on this subject based on the ideXlab platform.
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community based intervention packages for reducing maternal and neonatal morbidity and Mortality and improving neonatal outcomes
Cochrane Database of Systematic Reviews, 2015Co-Authors: Zohra S Lassi, Batool A Haider, Zulfiqar A BhuttaAbstract:Background While maternal, infant and under-five child Mortality rates in developing countries have declined significantly in the past two to three decades, Newborn Mortality rates have reduced much more slowly. While it is recognised that almost half of the Newborn deaths can be prevented by scaling up evidence-based available interventions such as tetanus toxoid immunisation to mothers; clean and skilled care at delivery; Newborn resuscitation; exclusive breastfeeding; clean umbilical cord care; management of infections in Newborns, many require facility based and outreach services. It has also been stated that a significant proportion of these mortalities and morbidities could also be potentially addressed by developing community-based packages interventions which should also be supplemented by developing and strengthening linkages with the local health systems. Some of the recent community-based studies of interventions targeting women of reproductive age have shown variable impacts on maternal outcomes and hence it is uncertain if these strategies have consistent benefit across the continuum of maternal and Newborn care. The objective of this review is to assess the effectiveness of community-based intervention packages in reducing maternal and neonatal morbidity and Mortality; and improving neonatal outcomes.
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Emollient therapy for preterm Newborn infants--evidence from the developing world.
BMC public health, 2013Co-Authors: Rosalina Abdul Salam, Jai K Das, Gary L. Darmstadt, Zulfiqar A BhuttaAbstract:INTRODUCTION: Application of emollients is a widespread traditional Newborn care practice in many low and middle-income countries (LMICs) and may have the potential to decrease infection and consequent Mortality in preterm neonates. METHODS: We systematically reviewed literature published up to December 2012 to identify studies describing the effectiveness of emollient therapy. We used a standardized abstraction and grading format to estimate the effect of emollient therapy by applying the standard Child Health Epidemiology Reference Group (CHERG) rules. RESULTS: We included seven studies and one unpublished trial in this review. Topical emollient therapy significantly reduced neonatal Mortality by 27% (RR: 0.73, 95% CI: 0.56, 0.94) and hospital acquired infection by 50% (RR: 0.50, 95% CI: 0.36, 0.71). There were significant increases in weight (g) (MD: 98.04, 95% CI: 42.64, 153.45) and weight gain (g/kg/day) (MD: 1.57, 95% CI: 0.79, 2.36), whereas the impacts were non-significant for length and head circumference. CONCLUSION: Emollient therapy is associated with improved weight gain, reduced risk of infection and associated Newborn Mortality in preterm neonates and is a potentially promising intervention for use in low resource settings. Large scale effectiveness trials are required to further assess the impact of this intervention.
Shivaprasad S. Goudar - One of the best experts on this subject based on the ideXlab platform.
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Maternal and Newborn outcomes in Pakistan compared to other low and middle income countries in the Global Network’s Maternal Newborn Health Registry: an active, community-based, pregnancy surveillance mechanism
Reproductive Health, 2015Co-Authors: Omrana Pasha, Sarah Saleem, Shivaprasad S. Goudar, Ana Garces, Fabian Esamai, Archana Patel, Elwyn Chomba, Fernando Althabe, Janet MooreAbstract:Background Despite global improvements in maternal and Newborn health (MNH), maternal, fetal and Newborn Mortality rates in Pakistan remain stagnant. Using data from the Global Network’s Maternal Newborn Health Registry (MNHR) the objective of this study is to compare the rates of maternal Mortality, stillbirth and Newborn Mortality and levels of putative risk factors between the Pakistani site and those in other countries.
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Establishment of a Maternal Newborn Health Registry in the Belgaum District of Karnataka, India
Reproductive Health, 2015Co-Authors: Bhalachandra S. Kodkany, Shivaprasad S. Goudar, Janet Moore, Nancy L Sloan, Elizabeth M. Mcclure, Richard J. Derman, Narayan V Honnungar, Naresh K Tyagi, Shivanand C Mastiholi, Robert L. GoldenbergAbstract:Background Pregnancy-related vital registration is important to inform policy to reduce maternal, fetal and Newborn Mortality, yet few systems for capturing accurate data are available in low-middle income countries where the majority of the Mortality occurs. Furthermore, methods to effectively implement high-quality registration systems have not been described. The goal of creating the registry described in this paper was to inform public health policy makers about pregnancy outcomes in our district so that appropriate interventions to improve these outcomes could be undertaken and to position the district to be a leader in pregnancy-related public health research.
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Global network for women’s and children’s health research: a system for low-resource areas to determine probable causes of stillbirth, neonatal, and maternal death
Maternal Health Neonatology and Perinatology, 2015Co-Authors: Elizabeth M. Mcclure, Omrana Pasha, Shivaprasad S. Goudar, Ana Garces, Fabian Esamai, Archana Patel, Elwyn Chomba, Carl L. Bose, Antoinette Tshefu, Bhalchandra S. KodkanyAbstract:Background Determining cause of death is needed to develop strategies to reduce maternal death, stillbirth, and Newborn death, especially for low-resource settings where 98% of deaths occur. Most existing classification systems are designed for high income settings where extensive testing is available. Verbal autopsy or audits, developed as an alternative, are time-intensive and not generally feasible for population-based evaluation. Furthermore, because most classification is user-dependent, reliability of classification varies over time and across settings. Thus, we sought to develop classification systems for maternal, fetal and Newborn Mortality based on minimal data to produce reliable cause-of-death estimates for low-resource settings.
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stillbirth and Newborn Mortality in india after helping babies breathe training
Pediatrics, 2013Co-Authors: Shivaprasad S. Goudar, Manjunath S Somannavar, Robert S B Clark, Jocelyn Lockyer, Amit P Revankar, Herta Fidler, Nancy L Sloan, Susan Niermeyer, William J Keenan, Nalini SinghalAbstract:OBJECTIVE: This study evaluated the effectiveness of Helping Babies Breathe (HBB) Newborn care and resuscitation training for birth attendants in reducing stillbirth (SB), and predischarge and neonatal Mortality (NMR). India contributes to a large proportion of the worlds annual 3.1 million neonatal deaths and 2.6 million SBs. METHODS: This prospective study included 4187 births at >28 weeks’ gestation before and 5411 births after HBB training in Karnataka. A total of 599 birth attendants from rural primary health centers and district and urban hospitals received HBB training developed by the American Academy of Pediatrics, using a train-the-trainer cascade. Pre-post written trainee knowledge, posttraining provider performance and skills, SB, predischarge Mortality, and NMR before and after HBB training were assessed by using χ 2 and t -tests for categorical and continuous variables, respectively. Backward stepwise logistic regression analysis adjusted for potential confounding. RESULTS: Provider knowledge and performance systematically improved with HBB training. HBB training reduced resuscitation but increased assisted bag and mask ventilation incidence. SB declined from 3.0% to 2.3% (odds ratio [OR] 0.76, 95% confidence interval [CI] 0.59–0.98) and fresh SB from 1.7% to 0.9% (OR 0.54, 95% CI 0.37–0.78) after HBB training. Predischarge Mortality was 0.1% in both periods. NMR was 1.8% before and 1.9% after HBB training (OR 1.09, 95% CI 0.80–1.47, P = .59) but unknown status at 28 days was 2% greater after HBB training ( P = .007). CONCLUSIONS: HBB training reduced SB without increasing NMR, indicating that resuscitated infants survived the neonatal period. Monitoring and community-based assessment are recommended.
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Communities, birth attendants and health facilities: a continuum of emergency maternal and Newborn care (the global network's EmONC trial)
BMC Pregnancy and Childbirth, 2010Co-Authors: Omrana Pasha, Sarah Saleem, Shivaprasad S. Goudar, Ana Garces, Fabian Esamai, Archana Patel, Fernando Althabe, Robert L. Goldenberg, Elizabeth M. Mcclure, Elwyn ChombaAbstract:Background Maternal and Newborn Mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and Newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes.
Tanja A J Houweling - One of the best experts on this subject based on the ideXlab platform.
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reaching the poor with health interventions programme incidence analysis of seven randomised trials of women s groups to reduce Newborn Mortality in asia and africa
Journal of Epidemiology and Community Health, 2016Co-Authors: Tanja A J Houweling, Joanna Morrison, Glyn Alcock, Kishwar Azad, Munir Hossen, Abdul Kuddus, Sonia Lewycka, Caspar W N Looman, Bharat Budhathoki MagarAbstract:Background Efforts to end preventable Newborn deaths will fail if the poor are not reached with effective interventions. To understand what works to reach vulnerable groups, we describe and explain the uptake of a highly effective community-based Newborn health intervention across social strata in Asia and Africa. Methods We conducted a secondary analysis of seven randomised trials of participatory women9s groups to reduce Newborn Mortality in India, Bangladesh, Nepal and Malawi. We analysed data on 70 574 pregnancies. Socioeconomic and sociodemographic differences in group attendance were tested using logistic regression. Qualitative data were collected at each trial site (225 focus groups, 20 interviews) to understand our results. Results Socioeconomic differences in women9s group attendance were small, except for occasional lower attendance by elites. Sociodemographic differences were large, with lower attendance by young primigravid women in African as well as in South Asian sites. The intervention was considered relevant and interesting to all socioeconomic groups. Local facilitators ensured inclusion of poorer women. Embarrassment and family constraints on movement outside the home restricted attendance among primigravid women. Reproductive health discussions were perceived as inappropriate for them. Conclusions Community-based women9s groups can help to reach every Newborn with effective interventions. Equitable intervention uptake is enhanced when facilitators actively encourage all women to attend, organise meetings at the participants’ convenience and use approaches that are easily understandable for the less educated. Focused efforts to include primigravid women are necessary, working with families and communities to decrease social taboos.
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The effect of participatory women's groups on birth outcomes in Bangladesh: does coverage matter? Study protocol for a randomized controlled trial
Trials, 2011Co-Authors: Tanja A J Houweling, Kishwar Azad, Abdul Kuddus, Layla Younes, Sanjit Shaha, Tasmin Nahar, James Beard, Edward F Fottrell, Audrey ProstAbstract:Background Progress on neonatal survival has been slow in most countries. While there is evidence on what works to reduce Newborn Mortality, there is limited knowledge on how to deliver interventions effectively when health systems are weak. Cluster randomized trials have shown strong reductions in neonatal Mortality using community mobilisation with women's groups in rural Nepal and India. A similar trial in Bangladesh showed no impact. A main hypothesis is that this negative finding is due to the much lower coverage of women's groups in the intervention population in Bangladesh compared to India and Nepal. For evidence-based policy making it is important to examine if women's group coverage is a main determinant of their impact. The study aims to test the effect on Newborn and maternal health outcomes of a participatory women's group intervention with a high population coverage of women's groups.
Pauline F. D. Scheelbeek - One of the best experts on this subject based on the ideXlab platform.
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Effects of family conversation on health care practices in Ethiopia: a propensity score matched analysis
BMC Pregnancy and Childbirth, 2018Co-Authors: Dessalew Emaway Altaye, Ali Mehryar Karim, Wuleta Betemariam, Nebreed Fesseha Zemichael, Tesfaye Shigute, Pauline F. D. ScheelbeekAbstract:Background Maternal and Newborn Mortality rates in Ethiopia are among the highest in sub-Saharan Africa. The majority of deaths take place during childbirth or within the following 48 h. Therefore, ensuring facility deliveries with emergency obstetric and Newborn care services available and immediate postnatal follow-up are key strategies to increase survival. In early 2014, the Family Conversation was implemented in 115 rural districts in Ethiopia, covering about 17 million people. It aimed to reduce maternal and Newborn Mortality by promoting institutional delivery, early postnatal care and immediate Newborn care practices. More than 6000 Health Extension Workers were trained to initiate home-based Family Conversations with pregnant women and key household decision-makers. These conversations included discussions on birth preparedness, postpartum and Newborn care needs to engage key household stakeholders in supporting women during their pregnancy, labor and postpartum periods. This paper examines the effects of the Family Conversation strategy on maternal and neonatal care practices.
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Effects of family conversation on health care practices in Ethiopia: a propensity score matched analysis
BMC Pregnancy and Childbirth, 2018Co-Authors: Dessalew Emaway Altaye, Ali Mehryar Karim, Wuleta Betemariam, Tesfaye Shigute, Nebreed Fesseha Zemichael, Pauline F. D. ScheelbeekAbstract:Background Maternal and Newborn Mortality rates in Ethiopia are among the highest in sub-Saharan Africa. The majority of deaths take place during childbirth or within the following 48 h. Therefore, ensuring facility deliveries with emergency obstetric and Newborn care services available and immediate postnatal follow-up are key strategies to increase survival. In early 2014, the Family Conversation was implemented in 115 rural districts in Ethiopia, covering about 17 million people. It aimed to reduce maternal and Newborn Mortality by promoting institutional delivery, early postnatal care and immediate Newborn care practices. More than 6000 Health Extension Workers were trained to initiate home-based Family Conversations with pregnant women and key household decision-makers. These conversations included discussions on birth preparedness, postpartum and Newborn care needs to engage key household stakeholders in supporting women during their pregnancy, labor and postpartum periods. This paper examines the effects of the Family Conversation strategy on maternal and neonatal care practices. Methods We used cross-sectional data from a representative sample of 4684 women with children aged 0–11 months from 115 districts collected between December 2014 and January 2015. We compared intrapartum and Newborn care practices related to the most recent childbirth, between those who reported having participated in a Family Conversation during pregnancy, and those who had not. Propensity score matched analysis was used to estimate average treatment effects of the Family Conversation strategy on intrapartum and Newborn care practices, including institutional delivery, early postnatal and immediate breastfeeding. Results About 17% of the respondents reported having had a Family Conversation during their last pregnancy. Average treatment effects of 7, 12, 9 and 16 percentage-points respectively were found for institutional deliveries, early postnatal care, clean cord care and thermal care of the Newborn ( p
Mats Målqvist - One of the best experts on this subject based on the ideXlab platform.
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Quality of Care for Maternal and Newborn Health in Health Facilities in Nepal
Maternal and Child Health Journal, 2019Co-Authors: Ashish Kc, Dipendra Raman Singh, Madan Kumar Upadhyaya, Shyam Sundar Budhathoki, Abhishek Gurung, Mats MålqvistAbstract:Introduction Nepal has pledged to substantially reduce maternal and Newborn death by 2030. Improving quality of intrapartum health services will be vital to reduce these deaths. This paper examines quality of delivery and Newborn services in health facilities of Nepal. Methods Data were sourced from the Nepal Health Facility Survey 2015, which covered a national representative sample of health facilities. The datasets were analysed to assess service readiness, availability and quality of delivery and Newborn care in a sample of 992 health facilities. Results Of the 992 facilities in the sample, 623 provided delivery and Newborn care services. Of the 623 facilities offering delivery and Newborn care services, 13.3% offered comprehensive emergency obstetric care (CEmONC), 19.6% provided basic emergency obstetric care (BEmONC) and 53.9% provided basic delivery and Newborn service. The availability of essential equipment for delivery and Newborn care was more than 80% in health facilities. Except for the coverage of vitamin K injection, the coverage of immediate Newborn care was more than 85% in all health facilities. The coverage of use of chlorhexidine ointment to all Newborns was more than 70% in government hospitals and primary health care centers (PHCCs) and only 32.3% in private hospitals. Conclusions These findings show gaps in equipment and drugs, especially in PHCCs and private health facilities. Improving readiness and availability of equipment and drugs in PHCCs and private health facility will help improve the quality of care to further reduce maternal and Newborn Mortality in Nepal.
