Document Detail

Newborn care training of midwives and neonatal and perinatal mortality rates in a developing country.
MedLine Citation:
PMID:  20937659     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study was designed to test the hypothesis that 2 training programs would reduce incrementally 7-day neonatal mortality rates for low-risk institutional deliveries.
METHODS: Using a train-the-trainer model, certified research midwives sequentially trained the midwives who performed deliveries in low-risk, first-level, urban, community health clinics in 2 cities in Zambia in the protocol and data collection, in the World Health Organization Essential Newborn Care (ENC) course (universal precautions and cleanliness, routine neonatal care, resuscitation, thermoregulation, breastfeeding, kangaroo care, care of small infants, and common illnesses), and in the American Academy of Pediatrics Neonatal Resuscitation Program (in-depth basic resuscitation). Data were collected during 3 periods, after implementation of each training course.
RESULTS: A total of 71 689 neonates were enrolled in the 3 study periods. All-cause, 7-day neonatal mortality rates decreased from 11.5 deaths per 1000 live births to 6.8 deaths per 1000 live births after ENC training (relative risk: 0.59 [95% confidence interval: 0.48-0.77]; P < .001), because of decreases in rates of deaths attributable to birth asphyxia and infection. Perinatal mortality rates but not stillbirth rates decreased. The 7-day neonatal mortality rate was decreased further after Neonatal Resuscitation Program training, after correction for loss to follow-up monitoring.
CONCLUSIONS: ENC training for midwives reduced 7-day neonatal mortality rates in low-risk clinics. Additional in-depth basic training in neonatal resuscitation may reduce mortality rates further.
Waldemar A Carlo; Elizabeth M McClure; Elwyn Chomba; Hrishikesh Chakraborty; Tyler Hartwell; Hillary Harris; Ornella Lincetto; Linda L Wright
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-10-11
Journal Detail:
Title:  Pediatrics     Volume:  126     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e1064-71     Citation Subset:  AIM; IM    
Division of Neonatology, Department of Pediatrics, School of Medicine, University of Alabama at Birmingham, 9380 Women and Infants Center,1700 6th Ave South Birmingham, AL 35233, USA.
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MeSH Terms
Asphyxia Neonatorum / mortality,  prevention & control
Bacterial Infections / mortality,  prevention & control
Cause of Death
Developing Countries*
Follow-Up Studies
Infant, Newborn
Midwifery / education*
Neonatology / education*
Perinatal Mortality*
Prospective Studies
Resuscitation / education
Stillbirth / epidemiology
Urban Population*
Grant Support
Comment In:
Pediatrics. 2010 Nov;126(5):e1259-60   [PMID:  20974787 ]

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

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