Community-based perinatal and newborn care in rural Pakistan: a cluster randomised controlled trial

This reference is based in information provided by a systematic review (Lassi 2010) reporting unpublished data (ongoing trial). It has been prepared by collaborators of Epistemonikos.

POPULATION:

Pregnant women and other family members. Total number of births in trial period were 24,095 and live births were 23,033.

INTERVENTION:

Community-based interventions to reduce neonatal deaths due to birth asphyxia, neonatal sepsis and prematurity.
Lady Health Workers (LHW) = along with the basic training (for control group) they received additional training on recognition of high-risk pregnancies and referrals of low birth weight infants. Traditional birth attendants = along with the basic training (for control group) they received additional training on promotion of low birth weight attendance at births. Female and male supports groups (health committees) were formed/strengthened.
The LHW formed female health committee and male activists formed male health committees in the LHW catchment area. Meetings of both groups were arranged with the assistance of the community health committee and LHWs on monthly basis for dissemination of health messages and education related to maternal and newborn health and problems. Separate community group education sessions for mothers, mother in laws, married women especially with pregnancy and fathers, father in laws for health education of the communities were conducted through the supports groups in the LHW catchment area using educational material as flip charts on antenatal care, identification of danger signs related to pregnancy and recognition of simple risk factors for high-risk pregnancies and births (these include severe maternal malnutrition, illness, short stature, previous perinatal deaths etc), birth preparedness (transport, money, skilled birth attendant, facility), essential and immediate newborn care and recognition of danger signs and sepsis with early and appropriate referral.

CONTROL:

LHW training programme continued as usual, with regular refresher sessions, but no attempt was made to link LHWs with the Dais (local name for traditional birth attendants). They were however provided with regular refresher training according to the standard national LHW program curriculum including monthly debriefing sessions in public sector health facilities.

SETTING:

Rural areas of Pakistan.