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| Name | Class |
|---|---|
| Centre For International Health | OTHER |
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Universal coverage of good quality facility based care globally could prevent nearly 113,000 maternal deaths, 531,000 stillbirths and 1.3 million neonatal deaths annually by 2020. Yet, only 57% of pregnant Ugandan women choose to deliver at health facilities. This unacceptably low coverage of facility based births could explain, in part, the high maternal and perinatal mortality estimates in Uganda. While multiple studies have examined factors associated with this low utilization of health services around the time of birth, there is inadequate implementation research exploring the best systematic methods that could promote uptake and scale up of facility based births. This study will therefore examine the effect of an intervention package (peer counselling by pregnancy buddies on facility based births, mobile phone messaging promoting facility based births and provision of mama-kits) on the frequency of facility based births and perinatal mortality. The study, a cluster randomized community based intervention trial in post-conflict Northern Uganda, will provide data crucial in framing national policy regarding measures to promote the use of health facilities.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Intervention arm: An integrated package | Experimental | Pregnant women in the intervention clusters will receive an integrated package consisting of peer support for facility based births by pregnancy buddies, mama kits and mobile phone messages. These components will all aim at mitigating the three delays and increasing the proportion of facility based births. |
|
| Control arm: Standard of care | No Intervention | Pregnant women in the control clusters will continue to receive the standard of care for pregnant women according to Ugandan Ministry of Health guidelines |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Intervention arm: An integrated package | Behavioral | See description in previous column |
|
| Measure | Description | Time Frame |
|---|---|---|
| Facility based birth | Delivery at a health facility | Day 1 |
| Measure | Description | Time Frame |
|---|---|---|
| Neonatal death | Death within the first month of life | Day 28 |
| Timely initiation of breastfeeding | Initiation of breastfeeding with the first hour after birth |
| Measure | Description | Time Frame |
|---|---|---|
| Low birthweight | Proportion of infants with a birthweight =< 2500gms | Up-to 48 hours after birth |
| Preterm birth | Proportion of infants born at less than 37 completed weeks of gestation measured by the New Ballad Score |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Victoria Nankabirwa, MD, MPH, PhD | Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Makerere University | Principal Investigator |
| James K Tumwine, MD, PhD | Makerere University | Principal Investigator |
| Grace Ndeezi, MD, PhD | Makerere Univeristy | Principal Investigator |
| Thorkild Tylleskar, MD, PhD | University of Bergen | Principal Investigator |
| Paul Wako, MD, PhD | Busitema University | Principal Investigator |
| Joyce Kaducu | Gulu University | Principal Investigator |
| Jino Meleby | University of Juba | Principal Investigator |
| Frederik Froen, MD, PhD | Norwegian Institute of Public Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lira District | Lira | Uganda |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38326267 | Derived | Nankabirwa V, Mukunya D, Ndeezi G, Odongkara B, Arach AA, Achora V, Mugenyi L, Sebit MB, Wandabwa JN, Waako P, Tylleskar T, Tumwine JK. Can an integrated intervention package including peer support increase the proportion of health facility births? A cluster randomised controlled trial in Northern Uganda. BMJ Open. 2024 Feb 7;14(2):e070798. doi: 10.1136/bmjopen-2022-070798. | |
| 33574146 |
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The datasets used and/or analyzed during the current study will be available on reasonable request
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| ID | Term |
|---|---|
| D066087 | Perinatal Death |
| D047928 | Premature Birth |
| ID | Term |
|---|---|
| D011248 | Pregnancy Complications |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D003643 | Death |
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| Up-to one hour after birth |
| Severe illness | Severe illness within the first month of life | Day 28 |
| The percent of newborns attended by a health care pro-vider during the first 48 hours following birth | Proportion of babies seen by a health care work in the first 48 hours after birth | Up-to 48 hours after birth |
| The percent of newborns attended by a health care pro-vider during the first 7 days following birth | Proportion of babies seen by a health care work in the first one week after birth | 1 week |
| 7 days postpartum |
| Neonatal hypoglycemia | Proportion of infants with random blood glucose less than 47mg/dl | Up-to 7 days after birth |
| Derived |
| Mukunya D, Tumwine JK, Nankabirwa V, Odongkara B, Tongun JB, Arach AA, Tumuhamye J, Napyo A, Zalwango V, Achora V, Musaba MW, Ndeezi G, Tylleskar T. Neonatal hypothermia in Northern Uganda: a community-based cross-sectional study. BMJ Open. 2021 Feb 11;11(2):e041723. doi: 10.1136/bmjopen-2020-041723. |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007752 | Obstetric Labor, Premature |
| D007744 | Obstetric Labor Complications |