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| Name | Class |
|---|---|
| John Snow, Inc. | INDUSTRY |
| University of London | OTHER |
| UNICEF | OTHER |
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The purpose of the study is to determine whether community based management of infections with antibiotics administered by health extension workers reduce all cause mortality in neonates after the first day of life compared to current MOH IMNCI model of referral to hospital
Although 44% of neonatal deaths in Ethiopia are due to infection, access to treatment for neonatal infections is very low for most families. Even though the newly adapted Integrated Management of Newborn and Childhood Illness (IMNCI) package includes assessment of newborns, if a baby has any danger signs that may be suggestive of infection and is taken to health posts, the baby is to be referred to hospital for treatment. Given that only about 5% of neonatal deaths occur in hospitals and the distance to hospital is often far and the costs prohibitive, very few babies are likely to receive essential lifesaving antibiotics. Evidence from India, Bangladesh, and Nepal demonstrates that community health workers can effectively manage neonatal infections at home. However it is not known whether and community-based management of neonatal infections is effective, feasible and acceptable in the Ethiopian context. Local evidence regarding lives saved and cost is required in order to inform health policy and programming regarding community-based treatment of neonatal infections.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Arm1 | No Intervention | Make a diagnosis of Neonatal infections and refer patients according to IMNCI guideline | |
| 2 | Active Comparator | Health extension Workers will Make a diagnosis of Neonatal infections and treat with antibiotics when referal is not possible |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Community Based | Other | In Arm 2 health extension workers will make a diagnosis of Neonatal infection and treat with antibiotics |
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| Measure | Description | Time Frame |
|---|---|---|
| All cause Neonatal Mortality | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Additional cost for community based neonatal infection management | 2 years | |
| Adding identification and treatment of newborns and children to the package of services provided by HEWs/CHPs will not adversely affect the coverage of other services currently provided. |
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| Name | Affiliation | Role |
|---|---|---|
| Samuel T. Tesema, MD,Ped | Save the Children | Principal Investigator |
| Brian E. Mulligan, BSc, MPH | John Snow, Inc. | Principal Investigator |
| Tedbab D. HaileGebreil, MD, Ped | Save the Children/USA Ethiopia country office | Principal Investigator |
| Simon Ni Cousens, professor | London School of Hygiene and Tropical Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sidama, East shoa and West arsi Zones | Ādama | Sidama Region | Ethiopia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 11336143 | Background | Ahmed S, Sobhan F, Islam A, Barkat-e-Khuda. Neonatal morbidity and care-seeking behaviour in rural Bangladesh. J Trop Pediatr. 2001 Apr;47(2):98-105. doi: 10.1093/tropej/47.2.98. | |
| Background | Baqui AH et al. Early Findings from a Cluster-randomized Community-based Newborn Health Intervention Trial in Sylhet, Bangladesh. 8th Commonwealth Congress on Diarrhoea and Malnutrition (CAPGAN), 2006 | ||
| 10622298 |
| Label | URL |
|---|---|
| Official website for Save the Children | View source |
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| 2 years |
| Background |
| Bang AT, Bang RA, Baitule SB, Reddy MH, Deshmukh MD. Effect of home-based neonatal care and management of sepsis on neonatal mortality: field trial in rural India. Lancet. 1999 Dec 4;354(9194):1955-61. doi: 10.1016/S0140-6736(99)03046-9. |
| 15866863 | Background | Bhutta ZA, Darmstadt GL, Hasan BS, Haws RA. Community-based interventions for improving perinatal and neonatal health outcomes in developing countries: a review of the evidence. Pediatrics. 2005 Feb;115(2 Suppl):519-617. doi: 10.1542/peds.2004-1441. |
| Background | Lawn JE, Cousens S, Zupan J for the Lancet Neonatal Survival Steering Team. 4 million deaths: When? Where? Why? Published online March 3 2005. http://image.thelancet.com/extras/05art1073web.pdf. |
| Background | Lawn JE and Kerber K (eds) .Opportunities for Africa's Newborns: Practical data, policy and programmatic support for newborn care in Africa. The Partnership for Maternal, Newborn & Child Health (PMNCH), Cape Town 2006. ISBN-13: 978-0-620-37695-2. |
| 16556647 | Background | Lawn JE, Wilczynska-Ketende K, Cousens SN. Estimating the causes of 4 million neonatal deaths in the year 2000. Int J Epidemiol. 2006 Jun;35(3):706-18. doi: 10.1093/ije/dyl043. Epub 2006 Mar 23. |
| Background | FMOHa. Health Sector Development Programme -III Document. Federal Ministry of Health, Addis Ababa, Ethiopia, November 2005. |
| 10342698 | Background | Hayes RJ, Bennett S. Simple sample size calculation for cluster-randomized trials. Int J Epidemiol. 1999 Apr;28(2):319-26. doi: 10.1093/ije/28.2.319. |
| 28611102 | Derived | Degefie Hailegebriel T, Mulligan B, Cousens S, Mathewos B, Wall S, Bekele A, Russell J, Sitrin D, Tensou B, Lawn J, de Graft Johnson J, Legesse H, Hailu S, Nigussie A, Worku B, Baqui A. Effect on Neonatal Mortality of Newborn Infection Management at Health Posts When Referral Is Not Possible: A Cluster-Randomized Trial in Rural Ethiopia. Glob Health Sci Pract. 2017 Jun 27;5(2):202-216. doi: 10.9745/GHSP-D-16-00312. Print 2017 Jun 27. |