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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Communities, birth attendants and health facilities: A continuum of emergency maternal and newborn care (the global network's EmONC trial)
BMC Pregnancy and Childbirth, Volume 10, Article 82, Year 2010
Notification
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Description
Background: Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes.Methods/Design: We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each) across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis) and 28-day neonatal mortality.Discussion: In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant women and newborns in low-income countries.Trial Registration: ClinicalTrials.gov NCT01073488. © 2010 Pasha et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Pasha, Omrana
Pakistan, Karachi
The Aga Khan University
Goldenberg, Robert L.
United States, Philadelphia
Drexel University
McClure, Elizabeth M.
United States, Research Triangle Park
Rti International
Saleem, Sarah
Pakistan, Karachi
The Aga Khan University
Goudar, Shivaprasad S.
India, Belgaum
Jawaharlal Nehru Medical College Belgaum
Althabe, Fernando A.
Argentina, Buenos Aires
Universidad de Buenos Aires
Patel, Archana Behram
India, Nagpur
Government Medical College Nagpur
Esamai, Fabian O.
Kenya, Eldoret
Moi University
Garcés, Ana Lucía
Guatemala, Guatemala City
San Carlos University
Chomba, Elwyn Nachanya
Zambia, Lusaka
University of Zambia
Mazariegos, Manolo
Guatemala, Guatemala City
Eclamp
Kodkany, Bhalachandra S.
India, Belgaum
Jawaharlal Nehru Medical College Belgaum
Belizán, J.
Argentina, Buenos Aires
Universidad de Buenos Aires
Derman, Richard J.
Unknown Affiliation
Hibberd, Patricia L.
United States, Boston
International Health Organization
Carlo, Waldemar A.
United States, Birmingham
The University of Alabama at Birmingham
Liechty, Edward A.
United States, Bloomington
Indiana University Bloomington
Hambidge, K. Michael
United States, Denver
University of Colorado Denver
Buekens, Pierre M.
United States, New Orleans
Tulane University School of Public Health and Tropical Medicine
Wallace, Dennis D.
United States, Research Triangle Park
Rti International
Howard-Grabman, Lisa
United States, Broomfield
Trg Incorporated
Stalls, Suzanne
Unknown Affiliation
Koso-Thomas, Marion W.
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Jobe, Alan Hall
United States, Cincinnati
Cincinnati Children's Hospital
Wright, Linda L.
United States, Bethesda
National Institute of Child Health and Human Development Nichd
Statistics
Citations: 55
Authors: 25
Affiliations: 18
Identifiers
Doi:
10.1186/1471-2393-10-82
e-ISSN:
14712393
Research Areas
Health System And Policy
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Randomised Control Trial
Study Approach
Quantitative
Study Locations
Kenya
Zambia
Participants Gender
Female