title: Trends in use of referral hospital services for care of sick newborns in a community-based intervention in Tangail District, Bangladesh.
abstract: The Projahnmo-II Project in Mirzapur upazila (sub-district), Tangail district, Bangladesh, is promoting care-seeking for sick newborns through health education of families, identification and referral of sick newborns in the community by community health workers (CHWs), and strengthening of neonatal care in Kumudini Hospital, Mirzapur. Data were drawn from records maintained by the CHWs, referral hospital registers, a baseline household survey of recently-delivered women conducted from March to June 2003, and two interim household surveys in January and September 2005. Increases were observed in self-referral of sick newborns for care, compliance after referral by the CHWs, and care-seeking from qualified providers and from the Kumudini Hospital, and decreases were observed in care-seeking from unqualified providers in the intervention arm. An active surveillance for illness by the CHWs in the home, education of families by them on recognition of danger signs and counselling to seek immediate care for serious illness, and improved linkages between the community and the hospital can produce substantial increases in care-seeking for sick newborns.
authors.affiliation: ICDDR,B, GPO Box 128, Dhaka 1000, Bangladesh.
authors.forename: Sanwarul
authors.initials: S
authors.lastname: Bari
authors.forename: Ishtiaq
authors.initials: I
authors.lastname: Mannan
authors.forename: Mohammed Anisur
authors.initials: MA
authors.lastname: Rahman
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
authors.forename: M Habibur R
authors.initials: MH
authors.lastname: Serajil
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
authors.forename: Shams
authors.initials: S
authors.lastname: El Arifeen
authors.forename: Syed Moshfiqur
authors.initials: SM
authors.lastname: Rahman
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
authors.forename: A S M Nawshad Uddin
authors.initials: AS
authors.lastname: Ahmed
authors.forename: Saifuddin
authors.initials: S
authors.lastname: Ahmed
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Winch
mesh_terms: D001459:Bangladesh; D002662:Child Health Services / Q000706:statistics & numerical data / Q000639:trends*; D016000:Cluster Analysis; D003152:Community Health Nursing / Q000379:methods / Q000639:trends; D003695:Delivery of Health Care / Q000379:methods* / Q000639:trends; D005260:Female; D006266:Health Education / Q000706:statistics & numerical data / Q000639:trends*; D006293:Health Promotion; D006801:Humans; D007224:Infant Care / Q000592:standards; D007229:Infant Welfare; D007231:Infant, Newborn; D008297:Male; D008429:Maternal Welfare; D012017:Referral and Consultation