Open AccessTraining traditional birth attendants on the WHO Essential Newborn Care reduces perinatal mortality
Author(s) -
GARCÉS ANA,
MCCLURE ELIZABETH M.,
HAMBIDGE MICHAEL,
KREBS NANCY F.,
MAZARIEGOS MANOLO,
WRIGHT LINDA L.,
MOORE JANET,
CARLO WALDEMAR A
Publication year - 2012
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2012.01374.x
Subject(s) - medicine , population , obstetrics , infant mortality , prenatal care , pediatrics , pregnancy , mortality rate , environmental health , surgery , genetics , biology
Objectives. To evaluate the impact of birth attendant training using the World Health Organization Essential Newborn Care (ENC) course among traditional birth attendants, with a particular emphasis on the effect of acquisition of skills on perinatal outcomes. Design. Population‐based, prospective, interventional pre‐post design study. Setting. 11 rural clusters in Chimaltenango, Guatemala. Population. Health care providers. Methods. This study analyzed the effect of training and implementation of the ENC health care provider training course between September 2005 and December 2006. Outcome measures. The primary outcome measure was the rate of death from all causes in the first seven days after birth in fetuses/infants ≥1500g. Secondary outcome measures were overall rate of stillbirth, rate of perinatal death, which included stillbirths plus neonatal deaths in the first seven days in fetuses/infants ≥1500g. Results. Perinatal mortality decreased from 39.5/1000 pre‐ENC to 26.4 post‐ENC (RR 0.72; 95%CI 0.54–0.97). This reduction was attributable almost entirely to a decrease in the stillbirth rate of 21.4/1000 pre‐Essential Newborn Care to 7.9/1000 post‐ENC (RR 0.40; 95%CI 0.25–0.64). Seven‐day neonatal mortality did not decrease (18.3/1000 to 18.6/1000; RR 1.05; 95%CI 0.70–1.57). Conclusion. Essential Newborn Care training reduced stillbirths in a population‐based controlled study with deliveries conducted almost exclusively by traditional birth attendants. Scale‐up of this intervention in other settings might help assess reproducibility and sustainability.