Effects of essential newborn care training on fresh stillbirths and early neonatal deaths by maternal education.

Authors

Elwyn Chomba, University of Alabama at Birmingham, Birmingham, Ala., USA
Waldemar A. Waldemar A Carlo, University of Alabama at Birmingham, Birmingham, USA
Shivaprasad S. Goudar, KLE University's Jawaharlal Nehru Medical College, Belgaum, India
Imtiaz Jehan, Aga Khan UniversityFollow
Antoinette Tshefu, Kinshasa School of Public Health, Kinshasa, Democratic Republic of the Congo
Ana Garces, INCAP (Institute of Nutrition of Central America and Panama), Guatemala City, Guatemala
Sansita Parida, SCB Medical College, Cuttack, Odisha, India
Fernando Althabe, Institute for Clinical Effectiveness and Health Policy, Buenos Aires, Argentina
Elizabeth M. McClure, RTI International, Durham, N.C.
Richard J. Derman, Christiana Care Health Systems, Newark, Del.
Robert L. Goldenberg, Columbia University, New York, NY, USA.
Carl L. Bose, University of North Carolina, Chapel Hill, NC, USA.
Nancy F. Krebs, University of Colorado School of Medicine, Denver, CO, USA.
Puspamitra Panigrahi, University of Nebraska Medical Center, Omaha, Nebr.
Pierre Buekens, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
Debra Wallace, RTI International, Durham, N.C.
Moore J., RTI International, Durham, N.C.
Marion Koso-Thomas, NICHD, Bethesda, MD, USA.
Linda L. Wright, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Md., USA

Document Type

Article

Department

Community Health Sciences

Abstract

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.

Publication (Name of Journal)

Neonatology

Recommended Citation

Chomba, E., Waldemar A Carlo, W. A., Goudar, S. S., Jehan, I., Tshefu, A., Garces, A., Parida, S., Althabe, F., McClure, E. M., Derman, R. J., Goldenberg, R. L., Bose, C. L., Krebs, N. F., Panigrahi, P., Buekens, P., Wallace, D., J., M., Koso-Thomas, M., Wright, L. L. (2017). Effects of essential newborn care training on fresh stillbirths and early neonatal deaths by maternal education.. Neonatology, 111(1), 61-67.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/267