title: Effect of timing of first postnatal care home visit on neonatal mortality in Bangladesh: a observational cohort study.
abstract: OBJECTIVE
  To assess the effect of the timing of first postnatal home visit by community health workers on neonatal mortality.
  
  
  METHODS
  Analysis of prospectively collected data using time varying discrete hazard models to estimate hazard ratios for neonatal mortality according to day of first postnatal home visit.
  
  
  METHODS
  Data from a community based trial of neonatal care interventions conducted in Bangladesh during 2004-5.
  
  
  METHODS
  Neonatal mortality.
  
  
  RESULTS
  9211 live births were included. Among infants who survived the first day of life, neonatal mortality was 67% lower in those who received a visit on day one than in those who received no visit (adjusted hazard ratio 0.33, 95% confidence interval 0.23 to 0.46; P<0.001). For those infants who survived the first two days of life, receiving the first visit on the second day was associated with a 64% lower neonatal mortality than in those who did not receive a visit (adjusted hazard ratio 0.36, 0.23 to 0.55; P<0.001). First visits on any day after the second day of life were not associated with reduced mortality.
  
  
  CONCLUSIONS
  In developing countries, especially where home delivery with unskilled attendants is common, postnatal home visits within the first two days of life by trained community health workers can significantly reduce neonatal mortality.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. abaqui@jhsph.edu
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
authors.forename: Saifuddin
authors.initials: S
authors.lastname: Ahmed
authors.forename: Shams
authors.initials: S
authors.lastname: El Arifeen
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Rosecrans
authors.forename: Ishtiaq
authors.initials: I
authors.lastname: Mannan
authors.forename: Syed M
authors.initials: SM
authors.lastname: Rahman
authors.forename: Nazma
authors.initials: N
authors.lastname: Begum
authors.forename: Arif B A
authors.initials: AB
authors.lastname: Mahmud
authors.forename: Habibur R
authors.initials: HR
authors.lastname: Seraji
authors.forename: Emma K
authors.initials: EK
authors.lastname: Williams
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Winch
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.forename: Robert E
authors.initials: RE
authors.lastname: Black
mesh_terms: D001459:Bangladesh; D015331:Cohort Studies; D003152:Community Health Nursing / Q000458:organization & administration*; D004522:Educational Status; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D010298:Parity; D018743:Perinatal Care / Q000458:organization & administration*; D054238:Perinatal Mortality; D011181:Postnatal Care / Q000458:organization & administration*; D011247:Pregnancy; D016016:Proportional Hazards Models; D012923:Social Class; D013997:Time Factors
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