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Improving newborn care practices through home visits: lessons from Malawi, Nepal, Bangladesh, and Uganda.

Abstract：

BACKGROUND:Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. OBJECTIVE:This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. DESIGN:Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable - home visit from a community health worker (CHW) during pregnancy (0, 1-2, 3+) - and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. RESULTS:There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. CONCLUSION:Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of increasing facility delivery rates to ensure that all babies benefit from these practices.

journal_name

Glob Health Action

journal_title

Global health action

authors

Sitrin D,Guenther T,Waiswa P,Namutamba S,Namazzi G,Sharma S,Ashish KC,Rubayet S,Bhadra S,Ligowe R,Chimbalanga E,Sewell E,Kerber K,Moran A

doi

10.3402/gha.v8.23963

subject

Has Abstract

pub_date

2015-03-31 00:00:00

pages

23963

eissn

1654-9716

issn

1654-9880

pii

23963

journal_volume

pub_type

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Improving newborn care practices through home visits: lessons from Malawi, Nepal, Bangladesh, and Uganda.