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
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/107614

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network_acronym_str CONICETDig
repository_id_str 3498
network_name_str CONICET Digital (CONICET)
spelling 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
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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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