ENC training reduces perinatal mortality in Karnataka, India

Objective: To evaluate the effect of World Health Organization Essential Newborn Care course and the American Academy of Pediatrics Neonatal Resuscitation Program training on perinatal mortality in rural India. Methods: This study was part of a multi-country prospective, community-based cluster rand...

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Published in:The journal of maternal-fetal & neonatal medicine 2012-06, Vol.25 (6), p.568-574
Main Authors: Goudar, Shivaprasad S., Dhaded, Sangappa M., McClure, Elizabeth M., Derman, Richard J., Patil, Vishwanath D., Mahantshetti, Niranjana S., Bellad, Roopa M., Kodkany, Bhala, Moore, Janet, Wright, Linda L., Carlo, Waldemar A.
Format: Article
Language:English
Subjects:
Algorithms
Down-Regulation
essential newborn care
Female
Humans
India
India - epidemiology
Infant Care - methods
Infant Mortality
Infant, Newborn
Male
Midwifery - education
perinatal mortality
Perinatal Mortality - trends
Pregnancy
Rural Population - statistics & numerical data
Schools, Nursing
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Summary:Objective: To evaluate the effect of World Health Organization Essential Newborn Care course and the American Academy of Pediatrics Neonatal Resuscitation Program training on perinatal mortality in rural India. Methods: This study was part of a multi-country prospective, community-based cluster randomized controlled trial. Birth, 7-day and 28-day neonatal outcomes for all women with pregnancies greater than 28 weeks in the 26 study communities in Karnataka, India were included. Mortality rates pre- and post-Essential Newborn Care training were collected prospectively and then communities randomized to either receive neonatal resuscitation or refresher newborn care training in the control clusters. Results: Consent was obtained on 99% of the 25,096 births. Perinatal mortality for infants ≥500 g decreased from 52 to 36/1000 after newborn care training (RR 0.7; 95% CI 0.5, 0.9); stillbirth decreased from 23 to 14/1000 (RR 0.62; 95% CI 0.46, 0.83) and early neonatal mortality decreased from 29 to 22/1000 (RR 0.74; 95% CI 0.53, 1.03). Mortality was not reduced further with resuscitation training. Conclusions: Using a pre-post design, World Health Organization Essential Newborn Care community birth attendant training resulted in a significant reduction in perinatal mortality. In low-resource settings, the newborn care training package appears to be an effective intervention to decrease perinatal mortality.
ISSN:1476-7058
1476-4954
DOI:10.3109/14767058.2011.584088