TY - JOUR
T1 - The Uganda Newborn Study (UNEST)
T2 - An effectiveness study on improving newborn health and survival in rural Uganda through a community-based intervention linked to health facilities - study protocol for a cluster randomized controlled trial
AU - Waiswa, Peter
AU - Peterson, Stefan S.
AU - Namazzi, Gertrude
AU - Ekirapa, Elizabeth Kiracho
AU - Naikoba, Sarah
AU - Byaruhanga, Romano
AU - Kiguli, Juliet
AU - Kallander, Karin
AU - Tagoola, Abner
AU - Nakakeeto, Margaret
AU - Pariyo, George
N1 - Funding Information:
Funding for this study was provided by the Saving Newborn Lives of Save the Children USA/Uganda through a grant from the Bill & Melinda Gates Foundation. UNEST also benefited from funding support from the Sida/ SAREC-Makerere University-Karolinska Institutet Research collaboration grant. We also extend our thanks to the Ministry of Health Newborn Steering Committee, Iganga-Mayuge Demographic Surveillance Site, and Iganga and Mayuge districts with their managers, staff and community members. Special thanks to the many study advisers and members of the implementation team including Joy Lawn, Allisyn Moran, Kate Kerber, Claudia Morrissey, Shyam Tharpa, Daniel Kadobera, Gertrude Namazzi, Sarah Namusoko-Kalungi, James Kalungi, Sarah Namutamba, Ruth Namusabi, Joy Kisira, Maria Najjemba, Olive Ssentumbwe, Anthony Mbonye, Jesca Nsungwa-Sabiiti, Hanifa Sengendo, Patrick Aliganyira, Ronald Ssentuwa, Miriam Ssentongo, Geoffrey Bisoborwa, Janex Kabarangira, Judith Ajean, Victoria Nakibuuka and Gelasius K Mukasa. We also thank members of the study advisory board.
PY - 2012/11/15
Y1 - 2012/11/15
N2 - Background: Reducing neonatal-related deaths is one of the major bottlenecks to achieving Millennium Development Goal 4. Studies in Asia and South America have shown that neonatal mortality can be reduced through community-based interventions, but these have not been adapted to scalable intervention packages for sub-Saharan Africa where the culture, health system and policy environment is different. In Uganda, health outcomes are poor for both mothers and newborn babies. Policy opportunities for neonatal health include the new national Health Sector Strategic Plan, which now prioritizes newborn health including use of a community model through Village Health Teams (VHT). The aim of the present study is to adapt, develop and cost an integrated maternal-newborn care package that links community and facility care, and to evaluate its effect on maternal and neonatal practices in order to inform policy and scale-up in Uganda. Methods/Design: Through formative research around evidence-based practices, and dialogue with policy and technical advisers, we constructed a home-based neonatal care package implemented by the responsible VHT member, effectively a Community Health Worker (CHW). This CHW was trained to identify pregnant women and make five home visits - two before and three just after birth - so that linkages will be made to facility care and targeted messages for home-care and care-seeking delivered. The project is improving care in health units to provide standardized care for the mother and the newborn in both intervention and comparison areas.The study is taking place in a new Demographic Surveillance Site in two rural districts, Iganga and Mayuge, in Uganda. It is a two-arm cluster randomized controlled design with 31 intervention and 32 control areas (villages). The comparison parishes receive the standard care already being provided by the district, but to the intervention villages are added a system for CHWs to visit the mother five times in her home during pregnancy and the neonatal period. Both areas benefit from a standardized strengthening of facility care for mothers and neonates.Discussion: UNEST is designed to directly feed into the operationalization of maternal and newborn care in the national VHT strategy, thereby helping to inform scale-up in rural Uganda. The study is registered as a randomized controlled trial, number ISRCTN50321130.
AB - Background: Reducing neonatal-related deaths is one of the major bottlenecks to achieving Millennium Development Goal 4. Studies in Asia and South America have shown that neonatal mortality can be reduced through community-based interventions, but these have not been adapted to scalable intervention packages for sub-Saharan Africa where the culture, health system and policy environment is different. In Uganda, health outcomes are poor for both mothers and newborn babies. Policy opportunities for neonatal health include the new national Health Sector Strategic Plan, which now prioritizes newborn health including use of a community model through Village Health Teams (VHT). The aim of the present study is to adapt, develop and cost an integrated maternal-newborn care package that links community and facility care, and to evaluate its effect on maternal and neonatal practices in order to inform policy and scale-up in Uganda. Methods/Design: Through formative research around evidence-based practices, and dialogue with policy and technical advisers, we constructed a home-based neonatal care package implemented by the responsible VHT member, effectively a Community Health Worker (CHW). This CHW was trained to identify pregnant women and make five home visits - two before and three just after birth - so that linkages will be made to facility care and targeted messages for home-care and care-seeking delivered. The project is improving care in health units to provide standardized care for the mother and the newborn in both intervention and comparison areas.The study is taking place in a new Demographic Surveillance Site in two rural districts, Iganga and Mayuge, in Uganda. It is a two-arm cluster randomized controlled design with 31 intervention and 32 control areas (villages). The comparison parishes receive the standard care already being provided by the district, but to the intervention villages are added a system for CHWs to visit the mother five times in her home during pregnancy and the neonatal period. Both areas benefit from a standardized strengthening of facility care for mothers and neonates.Discussion: UNEST is designed to directly feed into the operationalization of maternal and newborn care in the national VHT strategy, thereby helping to inform scale-up in rural Uganda. The study is registered as a randomized controlled trial, number ISRCTN50321130.
KW - Africa
KW - Community health workers
KW - Newborn
KW - Trial
KW - UNEST
KW - Uganda
UR - http://www.scopus.com/inward/record.url?scp=84868706566&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84868706566&partnerID=8YFLogxK
U2 - 10.1186/1745-6215-13-213
DO - 10.1186/1745-6215-13-213
M3 - Article
C2 - 23153395
AN - SCOPUS:84868706566
SN - 1745-6215
VL - 13
JO - Trials
JF - Trials
M1 - 213
ER -