Newborn-Care Training and Perinatal Mortality in Developing Countries
- Autores
- Carlo, Waldemar A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Chomba, Elwyn; Tshefu, Antoinette; Garces, Ana; Sailajanandan, Parida; Althabe, Fernando; McClure, Elizabeth M.; Derman, Richard J.; Goldenberg, Robert L.; Bose, Carl; Krebs, Nancy F.; Panigrahi, Pinaki; Buekens, Pierre; Chakraborty, Hrishikesh; Hartwell, Tyler D.; Wright, Linda L.
- Año de publicación
- 2010
- Idioma
- inglés
- Tipo de recurso
- artículo
- Estado
- versión publicada
- Descripción
- BACKGROUND: Of the 3.7 million neonatal deaths and 3.3 million stillbirths each year, 98% occur in developing countries. An evaluation of community-based interventions designed to reduce the number of these deaths is needed. METHODS: With the use of a train-the-trainer model, local instructors trained birth attendants from rural communities in six countries (Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan, and Zambia) in the World Health Organization Essential Newborn Care course (which focuses on routine neonatal care, resuscitation, thermoregulation, breast-feeding, "kangaroo" [skin-to-skin] care, care of the small baby, and common illnesses) and (except in Argentina) in a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (which teaches basic resuscitation in depth). The Essential Newborn Care intervention was assessed among 57,643 infants with the use of a before-and-after design. The Neonatal Resuscitation Program intervention was assessed as a cluster-randomized, controlled trial involving 62,366 infants. The primary outcome was neonatal death in the first 7 days after birth. RESULTS: The 7-day follow-up rate was 99.2%. After birth attendants were trained in the Essential Newborn Care course, there was no significant reduction from baseline in the rate of neonatal death from all causes in the 7 days after birth (relative risk with training, 0.99; 95% confidence interval [CI], 0.81 to 1.22) or in the rate of perinatal death; there was a significant reduction in the rate of stillbirth (relative risk with training, 0.69; 95% CI, 0.54 to 0.88; P=0.003). In clusters of births in which attendants had been randomly assigned to receive training in the Neonatal Resuscitation Program, as compared with control clusters, there was no reduction in the rates of neonatal death in the 7 days after birth, stillbirth, or perinatal death. CONCLUSIONS: The rate of neonatal death in the 7 days after birth did not decrease after the introduction of Essential Newborn Care training of community-based birth attendants, although the rate of stillbirths was reduced. Subsequent training in the Neonatal Resuscitation Program did not significantly reduce the mortality rates. (ClinicalTrials.gov number, NCT00136708.)
Fil: Carlo, Waldemar A.. University of Alabama at Birmingahm; Estados Unidos
Fil: Goudar, Shivaprasad S.. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Jehan, Imtiaz. Aga Khan University; Pakistán
Fil: Chomba, Elwyn. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: Tshefu, Antoinette. No especifíca;
Fil: Garces, Ana. Universidad de San Carlos ; Guatemala
Fil: Sailajanandan, Parida. Sriramchandra Bhanja Medical College; India
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina
Fil: McClure, Elizabeth M.. No especifíca;
Fil: Derman, Richard J.. University of Missouri; Estados Unidos
Fil: Goldenberg, Robert L.. Drexel University College of Medicine; Estados Unidos
Fil: Bose, Carl. University of North Carolina; Estados Unidos
Fil: Krebs, Nancy F.. University of Colorado; Estados Unidos
Fil: Panigrahi, Pinaki. No especifíca;
Fil: Buekens, Pierre. Tulane School of Public Health and Tropical Medicine; Estados Unidos
Fil: Chakraborty, Hrishikesh. No especifíca;
Fil: Hartwell, Tyler D.. No especifíca;
Fil: Wright, Linda L.. National Institute of Child Health and Human Development; Estados Unidos - Materia
-
newborn care
perinatal mortality - Nivel de accesibilidad
- acceso abierto
- Condiciones de uso
- https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
- Repositorio
- Institución
- Consejo Nacional de Investigaciones Científicas y Técnicas
- OAI Identificador
- oai:ri.conicet.gov.ar:11336/107614
Ver los metadatos del registro completo
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Newborn-Care Training and Perinatal Mortality in Developing CountriesCarlo, Waldemar A.Goudar, Shivaprasad S.Jehan, ImtiazChomba, ElwynTshefu, AntoinetteGarces, AnaSailajanandan, ParidaAlthabe, FernandoMcClure, Elizabeth M.Derman, Richard J.Goldenberg, Robert L.Bose, CarlKrebs, Nancy F.Panigrahi, PinakiBuekens, PierreChakraborty, HrishikeshHartwell, Tyler D.Wright, Linda L.newborn careperinatal mortalityhttps://purl.org/becyt/ford/3.2https://purl.org/becyt/ford/3BACKGROUND: Of the 3.7 million neonatal deaths and 3.3 million stillbirths each year, 98% occur in developing countries. An evaluation of community-based interventions designed to reduce the number of these deaths is needed. METHODS: With the use of a train-the-trainer model, local instructors trained birth attendants from rural communities in six countries (Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan, and Zambia) in the World Health Organization Essential Newborn Care course (which focuses on routine neonatal care, resuscitation, thermoregulation, breast-feeding, "kangaroo" [skin-to-skin] care, care of the small baby, and common illnesses) and (except in Argentina) in a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (which teaches basic resuscitation in depth). The Essential Newborn Care intervention was assessed among 57,643 infants with the use of a before-and-after design. The Neonatal Resuscitation Program intervention was assessed as a cluster-randomized, controlled trial involving 62,366 infants. The primary outcome was neonatal death in the first 7 days after birth. RESULTS: The 7-day follow-up rate was 99.2%. After birth attendants were trained in the Essential Newborn Care course, there was no significant reduction from baseline in the rate of neonatal death from all causes in the 7 days after birth (relative risk with training, 0.99; 95% confidence interval [CI], 0.81 to 1.22) or in the rate of perinatal death; there was a significant reduction in the rate of stillbirth (relative risk with training, 0.69; 95% CI, 0.54 to 0.88; P=0.003). In clusters of births in which attendants had been randomly assigned to receive training in the Neonatal Resuscitation Program, as compared with control clusters, there was no reduction in the rates of neonatal death in the 7 days after birth, stillbirth, or perinatal death. CONCLUSIONS: The rate of neonatal death in the 7 days after birth did not decrease after the introduction of Essential Newborn Care training of community-based birth attendants, although the rate of stillbirths was reduced. Subsequent training in the Neonatal Resuscitation Program did not significantly reduce the mortality rates. (ClinicalTrials.gov number, NCT00136708.)Fil: Carlo, Waldemar A.. University of Alabama at Birmingahm; Estados UnidosFil: Goudar, Shivaprasad S.. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Jehan, Imtiaz. Aga Khan University; PakistánFil: Chomba, Elwyn. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: Tshefu, Antoinette. No especifíca; Fil: Garces, Ana. Universidad de San Carlos ; GuatemalaFil: Sailajanandan, Parida. Sriramchandra Bhanja Medical College; IndiaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; ArgentinaFil: McClure, Elizabeth M.. No especifíca; Fil: Derman, Richard J.. University of Missouri; Estados UnidosFil: Goldenberg, Robert L.. Drexel University College of Medicine; Estados UnidosFil: Bose, Carl. University of North Carolina; Estados UnidosFil: Krebs, Nancy F.. University of Colorado; Estados UnidosFil: Panigrahi, Pinaki. No especifíca; Fil: Buekens, Pierre. Tulane School of Public Health and Tropical Medicine; Estados UnidosFil: Chakraborty, Hrishikesh. No especifíca; Fil: Hartwell, Tyler D.. No especifíca; Fil: Wright, Linda L.. National Institute of Child Health and Human Development; Estados UnidosMassachusetts Medical Society2010-02info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/107614Carlo, Waldemar A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Chomba, Elwyn; Tshefu, Antoinette; et al.; Newborn-Care Training and Perinatal Mortality in Developing Countries; Massachusetts Medical Society; New England Journal of Medicine; 362; 7; 2-2010; 614-6230028-4793CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/doi/10.1056/NEJMsa0806033info:eu-repo/semantics/altIdentifier/url/https://www.nejm.org/doi/full/10.1056/NEJMsa0806033info:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T10:29:24Zoai:ri.conicet.gov.ar:11336/107614instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 10:29:24.88CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse |
dc.title.none.fl_str_mv |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
title |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
spellingShingle |
Newborn-Care Training and Perinatal Mortality in Developing Countries Carlo, Waldemar A. newborn care perinatal mortality |
title_short |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
title_full |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
title_fullStr |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
title_full_unstemmed |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
title_sort |
Newborn-Care Training and Perinatal Mortality in Developing Countries |
dc.creator.none.fl_str_mv |
Carlo, Waldemar A. Goudar, Shivaprasad S. Jehan, Imtiaz Chomba, Elwyn Tshefu, Antoinette Garces, Ana Sailajanandan, Parida Althabe, Fernando McClure, Elizabeth M. Derman, Richard J. Goldenberg, Robert L. Bose, Carl Krebs, Nancy F. Panigrahi, Pinaki Buekens, Pierre Chakraborty, Hrishikesh Hartwell, Tyler D. Wright, Linda L. |
author |
Carlo, Waldemar A. |
author_facet |
Carlo, Waldemar A. Goudar, Shivaprasad S. Jehan, Imtiaz Chomba, Elwyn Tshefu, Antoinette Garces, Ana Sailajanandan, Parida Althabe, Fernando McClure, Elizabeth M. Derman, Richard J. Goldenberg, Robert L. Bose, Carl Krebs, Nancy F. Panigrahi, Pinaki Buekens, Pierre Chakraborty, Hrishikesh Hartwell, Tyler D. Wright, Linda L. |
author_role |
author |
author2 |
Goudar, Shivaprasad S. Jehan, Imtiaz Chomba, Elwyn Tshefu, Antoinette Garces, Ana Sailajanandan, Parida Althabe, Fernando McClure, Elizabeth M. Derman, Richard J. Goldenberg, Robert L. Bose, Carl Krebs, Nancy F. Panigrahi, Pinaki Buekens, Pierre Chakraborty, Hrishikesh Hartwell, Tyler D. Wright, Linda L. |
author2_role |
author author author author author author author author author author author author author author author author author |
dc.subject.none.fl_str_mv |
newborn care perinatal mortality |
topic |
newborn care perinatal mortality |
purl_subject.fl_str_mv |
https://purl.org/becyt/ford/3.2 https://purl.org/becyt/ford/3 |
dc.description.none.fl_txt_mv |
BACKGROUND: Of the 3.7 million neonatal deaths and 3.3 million stillbirths each year, 98% occur in developing countries. An evaluation of community-based interventions designed to reduce the number of these deaths is needed. METHODS: With the use of a train-the-trainer model, local instructors trained birth attendants from rural communities in six countries (Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan, and Zambia) in the World Health Organization Essential Newborn Care course (which focuses on routine neonatal care, resuscitation, thermoregulation, breast-feeding, "kangaroo" [skin-to-skin] care, care of the small baby, and common illnesses) and (except in Argentina) in a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (which teaches basic resuscitation in depth). The Essential Newborn Care intervention was assessed among 57,643 infants with the use of a before-and-after design. The Neonatal Resuscitation Program intervention was assessed as a cluster-randomized, controlled trial involving 62,366 infants. The primary outcome was neonatal death in the first 7 days after birth. RESULTS: The 7-day follow-up rate was 99.2%. After birth attendants were trained in the Essential Newborn Care course, there was no significant reduction from baseline in the rate of neonatal death from all causes in the 7 days after birth (relative risk with training, 0.99; 95% confidence interval [CI], 0.81 to 1.22) or in the rate of perinatal death; there was a significant reduction in the rate of stillbirth (relative risk with training, 0.69; 95% CI, 0.54 to 0.88; P=0.003). In clusters of births in which attendants had been randomly assigned to receive training in the Neonatal Resuscitation Program, as compared with control clusters, there was no reduction in the rates of neonatal death in the 7 days after birth, stillbirth, or perinatal death. CONCLUSIONS: The rate of neonatal death in the 7 days after birth did not decrease after the introduction of Essential Newborn Care training of community-based birth attendants, although the rate of stillbirths was reduced. Subsequent training in the Neonatal Resuscitation Program did not significantly reduce the mortality rates. (ClinicalTrials.gov number, NCT00136708.) Fil: Carlo, Waldemar A.. University of Alabama at Birmingahm; Estados Unidos Fil: Goudar, Shivaprasad S.. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Jehan, Imtiaz. Aga Khan University; Pakistán Fil: Chomba, Elwyn. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: Tshefu, Antoinette. No especifíca; Fil: Garces, Ana. Universidad de San Carlos ; Guatemala Fil: Sailajanandan, Parida. Sriramchandra Bhanja Medical College; India Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina Fil: McClure, Elizabeth M.. No especifíca; Fil: Derman, Richard J.. University of Missouri; Estados Unidos Fil: Goldenberg, Robert L.. Drexel University College of Medicine; Estados Unidos Fil: Bose, Carl. University of North Carolina; Estados Unidos Fil: Krebs, Nancy F.. University of Colorado; Estados Unidos Fil: Panigrahi, Pinaki. No especifíca; Fil: Buekens, Pierre. Tulane School of Public Health and Tropical Medicine; Estados Unidos Fil: Chakraborty, Hrishikesh. No especifíca; Fil: Hartwell, Tyler D.. No especifíca; Fil: Wright, Linda L.. National Institute of Child Health and Human Development; Estados Unidos |
description |
BACKGROUND: Of the 3.7 million neonatal deaths and 3.3 million stillbirths each year, 98% occur in developing countries. An evaluation of community-based interventions designed to reduce the number of these deaths is needed. METHODS: With the use of a train-the-trainer model, local instructors trained birth attendants from rural communities in six countries (Argentina, Democratic Republic of Congo, Guatemala, India, Pakistan, and Zambia) in the World Health Organization Essential Newborn Care course (which focuses on routine neonatal care, resuscitation, thermoregulation, breast-feeding, "kangaroo" [skin-to-skin] care, care of the small baby, and common illnesses) and (except in Argentina) in a modified version of the American Academy of Pediatrics Neonatal Resuscitation Program (which teaches basic resuscitation in depth). The Essential Newborn Care intervention was assessed among 57,643 infants with the use of a before-and-after design. The Neonatal Resuscitation Program intervention was assessed as a cluster-randomized, controlled trial involving 62,366 infants. The primary outcome was neonatal death in the first 7 days after birth. RESULTS: The 7-day follow-up rate was 99.2%. After birth attendants were trained in the Essential Newborn Care course, there was no significant reduction from baseline in the rate of neonatal death from all causes in the 7 days after birth (relative risk with training, 0.99; 95% confidence interval [CI], 0.81 to 1.22) or in the rate of perinatal death; there was a significant reduction in the rate of stillbirth (relative risk with training, 0.69; 95% CI, 0.54 to 0.88; P=0.003). In clusters of births in which attendants had been randomly assigned to receive training in the Neonatal Resuscitation Program, as compared with control clusters, there was no reduction in the rates of neonatal death in the 7 days after birth, stillbirth, or perinatal death. CONCLUSIONS: The rate of neonatal death in the 7 days after birth did not decrease after the introduction of Essential Newborn Care training of community-based birth attendants, although the rate of stillbirths was reduced. Subsequent training in the Neonatal Resuscitation Program did not significantly reduce the mortality rates. (ClinicalTrials.gov number, NCT00136708.) |
publishDate |
2010 |
dc.date.none.fl_str_mv |
2010-02 |
dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://purl.org/coar/resource_type/c_6501 info:ar-repo/semantics/articulo |
format |
article |
status_str |
publishedVersion |
dc.identifier.none.fl_str_mv |
http://hdl.handle.net/11336/107614 Carlo, Waldemar A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Chomba, Elwyn; Tshefu, Antoinette; et al.; Newborn-Care Training and Perinatal Mortality in Developing Countries; Massachusetts Medical Society; New England Journal of Medicine; 362; 7; 2-2010; 614-623 0028-4793 CONICET Digital CONICET |
url |
http://hdl.handle.net/11336/107614 |
identifier_str_mv |
Carlo, Waldemar A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Chomba, Elwyn; Tshefu, Antoinette; et al.; Newborn-Care Training and Perinatal Mortality in Developing Countries; Massachusetts Medical Society; New England Journal of Medicine; 362; 7; 2-2010; 614-623 0028-4793 CONICET Digital CONICET |
dc.language.none.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
info:eu-repo/semantics/altIdentifier/doi/10.1056/NEJMsa0806033 info:eu-repo/semantics/altIdentifier/url/https://www.nejm.org/doi/full/10.1056/NEJMsa0806033 |
dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
eu_rights_str_mv |
openAccess |
rights_invalid_str_mv |
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/ |
dc.format.none.fl_str_mv |
application/pdf application/pdf |
dc.publisher.none.fl_str_mv |
Massachusetts Medical Society |
publisher.none.fl_str_mv |
Massachusetts Medical Society |
dc.source.none.fl_str_mv |
reponame:CONICET Digital (CONICET) instname:Consejo Nacional de Investigaciones Científicas y Técnicas |
reponame_str |
CONICET Digital (CONICET) |
collection |
CONICET Digital (CONICET) |
instname_str |
Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.name.fl_str_mv |
CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas |
repository.mail.fl_str_mv |
dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar |
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1844614300359983104 |
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13.070432 |