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