Impact of Community-Based Behaviour-Change Management on Perceived Neonatal Morbidity: A Cluster-Randomized Controlled Trial in Shivgarh, Uttar Pradesh, India.

Author(s): Willis JR, Kumar V, Mohanty S, Singh V, Kumar A, Singh JV, Misra RP, Awasthi S, Singh P, Gupta A, Baqui AH, Santosham M, Darmstadt GL

Affiliation(s): International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.

Publication date & source: 2011-12-06, J Trop Pediatr., [Epub ahead of print]

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.