+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Impact of a community-based perinatal and newborn preventive care package on perinatal and neonatal mortality in a remote mountainous district in Northern Pakistan

Impact of a community-based perinatal and newborn preventive care package on perinatal and neonatal mortality in a remote mountainous district in Northern Pakistan

Bmc Pregnancy and Childbirth 15: 106

There is limited evidence from community-based interventions to guide the development of effective maternal, perinatal and newborn care practices and services in developing countries. We evaluated the impact of a low-cost package of community-based interventions implemented through government sector lady health workers (LHWs) and community health workers (CHWs) of a NGO namely Aga Khan Health Services on perinatal and neonatal outcomes in a sub-population of the remote mountainous district of Gilgit, Northern Pakistan. The package was evaluated using quasi experimental design included promotion of antenatal care, adequate nutrition, skilled delivery and healthy newborn care practices. Control areas continued to receive the routine standard health services. The intervention areas received intervention package in addition to the routine standard health services. Outcome measures included changes in maternal and newborn-care practices and perinatal and neonatal mortality rates between the intervention and control areas. The intervention was implemented in a population of 283324 over a 18 months period. 3200 pregnant women received the intervention. Significant improvements in antenatal care (92% vs 76%, p < .001), TT vaccination (67% vs 47%, p < .001), institutional delivery (85% vs 71%, p < .001), cord application (51% vs 71%, p < .001), delayed bathing (15% vs 43%, p < .001), colostrum administration (83% vs 64%, p < .001), and initiation of breastfeeding within 1 hour after birth (55% vs 40%, p < .001) were seen in intervention areas compared with control areas. Our results indicate significant reductions in mortality rates in intervention areas as compared to control areas from baseline in perinatal mortality rate (from 47.1 to 35.3 per 1000 births, OR 0.62; 95% CI: 0.56-0.69; P 0.02) and neonatal mortality rates (from 26.0 to 22.8 per 1000 live births, 0.58; 95% CI: 0.48-0.68; P 0.03). The implementation of a set of low cost community-based intervention package within the health system settings in a mountainous region of Pakistan was found to be both feasible and beneficial. The interventions had a significant impact in reduction of the burden of perinatal and neonatal mortality. This study is registered, ClinicalTrial.gov NCT02412293 .

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 058058080

Download citation: RISBibTeXText

PMID: 25925407

DOI: 10.1186/s12884-015-0538-8

Related references

Improvement of perinatal and newborn care in rural Pakistan through community-based strategies: a cluster-randomised effectiveness trial. Lancet 377(9763): 403-412, 2011

Neonatal mortality and morbidity in a neonatal unit: impact of improved perinatal care in recent 10 years. Zhonghua Minguo Xiao Er Ke Yi Xue Hui Za Zhi Zhonghua Minguo Xiao Er Ke Yi Xue Hui 36(6): 405-410, 1995

The impact of Neonatal Resuscitation Program courses on mortality and morbidity of newborn infants with perinatal asphyxia. Brain and Development 30(1): 43-46, 2008

Newborn care training of midwives and neonatal and perinatal mortality rates in a developing country. Pediatrics 126(5): E1064-E1071, 2010

The implementation of unit-based perinatal mortality audit in perinatal cooperation units in the northern region of the Netherlands. Bmc Health Services Research 12: 195, 2012

Specialized perinatal care: impact on perinatal mortality. Canadian Medical Association Journal 116(5): 506-507, 1977

Changing patterns in regionalization of perinatal care and the impact on neonatal mortality. American Journal Of Obstetrics & Gynecology. 178(1 Part 1): 131-135,., 1998

Time trends in twin perinatal mortality in northern England, 1982-94. Northern Region Perinatal Mortality Survey Steering Group. Twin Research 1(4): 189-195, 1998

Reduction in perinatal mortality and neonatal morbidity in a community based level II+ nursery. Journal of Investigative Medicine 46(7): 263A, 1998

Implementing community-based perinatal care: results from a pilot study in rural Pakistan. Bulletin of the World Health Organization 86(6): 452-459, 2008

A community based surveillance system for perinatal and neonatal care. Indian Pediatrics 26(11): 1115-1121, 1989

Socio-demographic risk factors for perinatal mortality: A study of perinatal mortality in the French district of Seine-Saint-Denis. Acta Obstetricia et Gynecologica Scandinavica 77(8): 826-835, 1998

The perinatal information system ii. development of a software package for perinatal care. Journal of Perinatal Medicine 15(Suppl. 1): 222, 1987

Neonatal mortality and perinatal risk factors in rural southwestern Nigeria: a community-based prospective study. West African Journal of Medicine 29(1): 19-23, 2010

Topical application of chlorhexidine to neonatal umbilical cords for prevention of omphalitis and neonatal mortality in a rural district of Pakistan: a community-based, cluster-randomised trial. Lancet 379(9820): 1029-1036, 2012