Document Detail


Cost-effectiveness of essential newborn care training in urban first-level facilities.
MedLine Citation:
PMID:  21502223     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the cost-effectiveness of the World Health Organization (WHO) Essential Newborn Care (ENC) training of health care providers in first-level facilities in the 2 largest cities in Zambia.
METHODS: Data were extracted from a study in which the effectiveness of the ENC training was evaluated (including universal precautions and cleanliness, routine neonatal care, resuscitation, thermoregulation, breastfeeding, skin-to-skin care, care of the small infant, danger signs, and common illnesses). The costs to train an ENC instructor for each first-level delivery facility and the costs of salary/benefits for 2 coordinators responsible for maintenance of the program were recorded in 2005 US dollars. The incremental costs per life gained and per disability-adjusted life-year averted were calculated.
SETTING: A 5-day ENC training-of-trainers was conducted in Lusaka, Zambia, to certify 18 college-trained midwives as ENC instructors. The instructors trained all clinic midwives working in their first-level facilities as part of a before-and-after study of the effect of ENC training on early neonatal mortality conducted from Oct 2004 to Nov 2006.
RESULTS: All-cause 7-day (early) neonatal mortality decreased from 11.5 per 1000 to 6.8 per 1000 live births after ENC training of the clinic midwives (relative risk: 0.59; 95% confidence interval: 0.48-0.77; P < .001; 40 615 births). The intervention costs were $208 per life saved and $5.24 per disability-adjusted life-year averted.
CONCLUSIONS: ENC training of clinic midwives who provide care in low-risk facilities is a low-cost intervention that can reduce early neonatal mortality in these settings.
Authors:
Albert Manasyan; Elwyn Chomba; Elizabeth M McClure; Linda L Wright; Sara Krzywanski; Waldemar A Carlo;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-04-18
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-02     Completed Date:  2011-07-11     Revised Date:  2012-01-27    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1176-81     Citation Subset:  AIM; IM    
Affiliation:
University of Alabama at Birmingham, 9380 Women and Infants Center, 1700 6th Avenue South, Birmingham, AL 35233, USA.
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Care / organization & administration
Cost-Benefit Analysis
Developing Countries
Female
Health Care Costs
Health Personnel / economics*,  education
Humans
Infant Care / economics*,  standards
Infant Mortality / trends*
Infant, Newborn
Intervention Studies
Male
Nurse Midwives / economics,  education*
Pediatric Nursing / education
Program Evaluation
Risk Assessment
World Health Organization
Zambia
Grant Support
ID/Acronym/Agency:
R01 HD053055/HD/NICHD NIH HHS; U01 HD043464/HD/NICHD NIH HHS
Comments/Corrections
Comment In:
Evid Based Nurs. 2012 Jan;15(1):14-5   [PMID:  21954202 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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