Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education

• Autores: Chomba, Elwyn; Carlo, Wally A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Tshefu, Antoinette; Garces, Ana; Parida, Sailajandan; Althabe, Fernando; McClure, Elizabeth M.; Derman, Richard J.; Goldenberg, Robert L.; Bose, Carl; Krebs, Nancy F.; Panigrahi, Pinaki; Buekens, Pierre; Wallace, Dennis; Moore, Janet; Koso Thomas, Marion; Wright, Linda L.; First Breath Study Group
• Año de publicación: 2016
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: Developing Countries; Education; Low And Mid Resource Countries; Neonatal Mortality
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

Background: Infants of women with lower education levels are at higher risk for perinatal mortality. Objectives: We explored the impact of training birth attendants and pregnant women in the Essential Newborn Care (ENC) Program on fresh stillbirths (FSBs) and early (7-day) neonatal deaths (END) by maternal education level in developing countries. Methods: A train-the-trainer model was used with local instructors in rural communities in six countries (Argentina, Democratic Republic of the Congo, Guatemala, India, Pakistan, and Zambia). Data were collected using a pre-/post-active baseline controlled study design. Results: A total of 57,643 infants/mothers were enrolled. The follow-up rate at 7 days of age was 99.2%. The risk for FSB and END was higher for mothers with 0-7 years of education than for those with ≥8 years of education during both the pre- and post-ENC periods in unadjusted models and in models adjusted for confounding. The effect of ENC differed as a function of maternal education for FSB (interaction p = 0.041) without evidence that the effect of ENC differed as a function of maternal education for END. The model-based estimate of FSB risk was reduced among mothers with 0-7 years of education (19.7/1,000 live births pre-ENC, CI: 16.3, 23.0 vs. 12.2/1,000 live births post-ENC, CI: 16.3, 23.0, p < 0.001), but was not significantly different for mothers with ≥8 years of education, respectively. Conclusion: A low level of maternal education was associated with higher risk for FSB and END. ENC training was more effective in reducing FSB among mothers with low education levels.
Fil: Chomba, Elwyn. University Of Alabama At Birmingham; Estados Unidos. Centre For Infectious Disease Research In Zambia; Zambia. University Teaching Hospital Lusaka; Zambia
Fil: Carlo, Wally A.. University Of Alabama At Birmingham; Estados Unidos
Fil: Goudar, Shivaprasad S.. Kle University India; India
Fil: Jehan, Imtiaz. The Aga Khan University; Pakistán
Fil: Tshefu, Antoinette. Kinshasa School Of Public Health; República Democrática del Congo
Fil: Garces, Ana. Institute Of Nutrition Of Central America And Panama Guatemala; Guatemala
Fil: Parida, Sailajandan. SCB Medical College; India
Fil: Althabe, Fernando. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: McClure, Elizabeth M.. Rti International; Reino Unido
Fil: Derman, Richard J.. Christiana Care Health System; Estados Unidos
Fil: Goldenberg, Robert L.. Columbia University; Estados Unidos
Fil: Bose, Carl. University of North Carolina; Estados Unidos
Fil: Krebs, Nancy F.. University of Colorado; Estados Unidos
Fil: Panigrahi, Pinaki. University Of Nebraska Medical Center; Estados Unidos
Fil: Buekens, Pierre. Tulane University. School Of Public Health And Tropical Medicine; Estados Unidos
Fil: Wallace, Dennis. Christiana Care Health System; Estados Unidos
Fil: Moore, Janet. Christiana Care Health System; Estados Unidos
Fil: Koso Thomas, Marion. National Instituto Of Child Health & Human Development; Estados Unidos
Fil: Wright, Linda L.. National Instituto Of Child Health & Human Development; Estados Unidos
Fil: First Breath Study Group. No especifica;