title: Impact of community-based behaviour-change management on perceived neonatal morbidity: a cluster-randomized controlled trial in Shivgarh, Uttar Pradesh, India.
abstract: In the context of high neonatal mortality rate (NMR) in developing country settings, a promising strategy for enhancing newborn health is promotion of preventive newborn care practices. We measured the effect of a behaviour-change intervention on perceived neonatal illnesses in rural Uttar Pradesh, India. The study was nested in a cluster-randomized controlled trial of the impact of a package of essential newborn care on NMR. We prospectively enrolled 802 mothers and administered a questionnaire on perceived neonatal morbidities. Regression analysis showed that newborns in the intervention clusters had significantly lower risk of perceived diarrhoea [adjusted relative risk (aRR) 0.67, 95% confidence interval (CI) 0.49-0.90] and skin-related complications [aRR 0.67, 95% CI 0.45-1.00] compared to newborns in the comparison area. Assuming incidence of perceived illnesses is a proxy for actual morbidity rates, we conclude that promotion of preventive care practices through behaviour-change interventions was effective in reducing neonatal morbidities.
authors.affiliation: International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Willis
authors.forename: Vishwajeet
authors.initials: V
authors.lastname: Kumar
authors.forename: Saroj
authors.initials: S
authors.lastname: Mohanty
authors.forename: Vivek
authors.initials: V
authors.lastname: Singh
authors.forename: Aarti
authors.initials: A
authors.lastname: Kumar
authors.forename: Jai V
authors.initials: JV
authors.lastname: Singh
authors.forename: Rajendra P
authors.initials: RP
authors.lastname: Misra
authors.forename: Shally
authors.initials: S
authors.lastname: Awasthi
authors.forename: Pramod
authors.initials: P
authors.lastname: Singh
authors.forename: Amit
authors.initials: A
authors.lastname: Gupta
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Baqui
authors.forename: Mathuram
authors.initials: M
authors.lastname: Santosham
authors.forename: Gary L
authors.initials: GL
authors.lastname: Darmstadt
mesh_terms: D000328:Adult; D001519:Behavior; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D016000:Cluster Analysis; D003153:Community Health Services / Q000379:methods / Q000458:organization & administration*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D009017:Morbidity; D009035:Mothers / Q000193:education; D017063:Outcome Assessment, Health Care; D010465:Perception; D011247:Pregnancy; D011314:Preventive Health Services / Q000379:methods / Q000458:organization & administration*; D015397:Program Evaluation; D011446:Prospective Studies; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires