TY - JOUR
T1 - Communities, birth attendants and health facilities
T2 - A continuum of emergency maternal and newborn care (the global network's EmONC trial)
AU - Pasha, Omrana
AU - Goldenberg, Robert L.
AU - McClure, Elizabeth M.
AU - Saleem, Sarah
AU - Goudar, Shivaprasad S.
AU - Althabe, Fernando
AU - Patel, Archana
AU - Esamai, Fabian
AU - Garces, Ana
AU - Chomba, Elwyn
AU - Mazariegos, Manolo
AU - Kodkany, Bhala
AU - Belizan, Jose M.
AU - Derman, Richard J.
AU - Hibberd, Patricia L.
AU - Carlo, Waldemar A.
AU - Liechty, Edward A.
AU - Hambidge, K. Michael
AU - Buekens, Pierre
AU - Wallace, Dennis
AU - Howard-Grabman, Lisa
AU - Stalls, Suzanne
AU - Koso-Thomas, Marion
AU - Jobe, Alan H.
AU - Wright, Linda L.
N1 - Funding Information:
The Global Network for Women’s and Children’s Health Research (Global Network) is a multi-site trial funded by the National Institute of Child Health and Human Development (NICHD). The trial is supervised by the Global Network’s EmONC Trial Subcommittee which consists of all site investigators, and the principal investigator and a senior statistician from the Data Coordinating Center (DCC) and the NICHD Director of the Global Network (Figure 1). The EmONC Trial Subcommittee convenes monthly by conference call and meets biannually to oversee study implementation, data analyses and publications.
Funding Information:
This project is being funded by the Eunice Kennedy Shriver National Institute of Child health and Human Development (NICHD), of the National Institutes of Health in the United States. The authors of this paper have no competing interests to declare.
PY - 2010/12/14
Y1 - 2010/12/14
N2 - Background: Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes.Methods/Design: We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each) across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis) and 28-day neonatal mortality.Discussion: In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant women and newborns in low-income countries.Trial Registration: ClinicalTrials.gov NCT01073488.
AB - Background: Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes.Methods/Design: We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each) across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis) and 28-day neonatal mortality.Discussion: In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant women and newborns in low-income countries.Trial Registration: ClinicalTrials.gov NCT01073488.
UR - http://www.scopus.com/inward/record.url?scp=78649999662&partnerID=8YFLogxK
U2 - 10.1186/1471-2393-10-82
DO - 10.1186/1471-2393-10-82
M3 - Article
C2 - 21156060
AN - SCOPUS:78649999662
SN - 1471-2393
VL - 10
JO - BMC Pregnancy and Childbirth
JF - BMC Pregnancy and Childbirth
M1 - 82
ER -
