Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education

Elwyn Chomba, Wally A. Carlo, Shivaprasad S. Goudar, Imtiaz Jehan, Antoinette Tshefu, Ana Garces, Sailajandan Parida, Fernando Althabe, Elizabeth M. McClure, Richard J. Derman, Robert L. Goldenberg, Carl Bose, Nancy F. Krebs, Pinaki Panigrahi, Pierre Buekens, Dennis Wallace, Janet Moore, Marion Koso-Thomas, Linda L. Wright

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Infants of women with lower education levels are at higher risk for perinatal mortality. Objectives: We explored the impact of training birth attendants and pregnant women in the Essential Newborn Care (ENC) Program on fresh stillbirths (FSBs) and early (7-day) neonatal deaths (END) by maternal education level in developing countries. Methods: A train-the-trainer model was used with local instructors in rural communities in six countries (Argentina, Democratic Republic of the Congo, Guatemala, India, Pakistan, and Zambia). Data were collected using a pre-/post-active baseline controlled study design. Results: A total of 57,643 infants/mothers were enrolled. The follow-up rate at 7 days of age was 99.2%. The risk for FSB and END was higher for mothers with 0-7 years of education than for those with ≥8 years of education during both the pre- and post-ENC periods in unadjusted models and in models adjusted for confounding. The effect of ENC differed as a function of maternal education for FSB (interaction p = 0.041) without evidence that the effect of ENC differed as a function of maternal education for END. The model-based estimate of FSB risk was reduced among mothers with 0-7 years of education (19.7/1,000 live births pre-ENC, CI: 16.3, 23.0 vs. 12.2/1,000 live births post-ENC, CI: 16.3, 23.0, p < 0.001), but was not significantly different for mothers with ≥8 years of education, respectively. Conclusion: A low level of maternal education was associated with higher risk for FSB and END. ENC training was more effective in reducing FSB among mothers with low education levels.

Original languageEnglish (US)
Pages (from-to)61-67
Number of pages7
JournalNeonatology
Volume111
Issue number1
DOIs
StatePublished - Dec 1 2016

Fingerprint

Stillbirth
Mothers
Newborn Infant
Education
Live Birth
Perinatal Death
Guatemala
Zambia
Democratic Republic of the Congo
Perinatal Mortality
Pakistan
Argentina
Rural Population
Developing Countries
Pregnant Women
India
Parturition

Keywords

  • Developing countries
  • Education
  • Low and mid resource countries
  • Neonatal mortality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental Biology

Cite this

Chomba, E., Carlo, W. A., Goudar, S. S., Jehan, I., Tshefu, A., Garces, A., ... Wright, L. L. (2016). Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education. Neonatology, 111(1), 61-67. https://doi.org/10.1159/000447421

Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education. / Chomba, Elwyn; Carlo, Wally A.; Goudar, Shivaprasad S.; Jehan, Imtiaz; Tshefu, Antoinette; Garces, Ana; Parida, Sailajandan; Althabe, Fernando; McClure, Elizabeth M.; Derman, Richard J.; Goldenberg, Robert L.; Bose, Carl; Krebs, Nancy F.; Panigrahi, Pinaki; Buekens, Pierre; Wallace, Dennis; Moore, Janet; Koso-Thomas, Marion; Wright, Linda L.

In: Neonatology, Vol. 111, No. 1, 01.12.2016, p. 61-67.

Research output: Contribution to journalArticle

Chomba, E, Carlo, WA, Goudar, SS, Jehan, I, Tshefu, A, Garces, A, Parida, S, Althabe, F, McClure, EM, Derman, RJ, Goldenberg, RL, Bose, C, Krebs, NF, Panigrahi, P, Buekens, P, Wallace, D, Moore, J, Koso-Thomas, M & Wright, LL 2016, 'Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education', Neonatology, vol. 111, no. 1, pp. 61-67. https://doi.org/10.1159/000447421
Chomba, Elwyn ; Carlo, Wally A. ; Goudar, Shivaprasad S. ; Jehan, Imtiaz ; Tshefu, Antoinette ; Garces, Ana ; Parida, Sailajandan ; Althabe, Fernando ; McClure, Elizabeth M. ; Derman, Richard J. ; Goldenberg, Robert L. ; Bose, Carl ; Krebs, Nancy F. ; Panigrahi, Pinaki ; Buekens, Pierre ; Wallace, Dennis ; Moore, Janet ; Koso-Thomas, Marion ; Wright, Linda L. / Effects of Essential Newborn Care Training on Fresh Stillbirths and Early Neonatal Deaths by Maternal Education. In: Neonatology. 2016 ; Vol. 111, No. 1. pp. 61-67.
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AU - Carlo, Wally A.

AU - Goudar, Shivaprasad S.

AU - Jehan, Imtiaz

AU - Tshefu, Antoinette

AU - Garces, Ana

AU - Parida, Sailajandan

AU - Althabe, Fernando

AU - McClure, Elizabeth M.

AU - Derman, Richard J.

AU - Goldenberg, Robert L.

AU - Bose, Carl

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AU - Panigrahi, Pinaki

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N2 - Background: Infants of women with lower education levels are at higher risk for perinatal mortality. Objectives: We explored the impact of training birth attendants and pregnant women in the Essential Newborn Care (ENC) Program on fresh stillbirths (FSBs) and early (7-day) neonatal deaths (END) by maternal education level in developing countries. Methods: A train-the-trainer model was used with local instructors in rural communities in six countries (Argentina, Democratic Republic of the Congo, Guatemala, India, Pakistan, and Zambia). Data were collected using a pre-/post-active baseline controlled study design. Results: A total of 57,643 infants/mothers were enrolled. The follow-up rate at 7 days of age was 99.2%. The risk for FSB and END was higher for mothers with 0-7 years of education than for those with ≥8 years of education during both the pre- and post-ENC periods in unadjusted models and in models adjusted for confounding. The effect of ENC differed as a function of maternal education for FSB (interaction p = 0.041) without evidence that the effect of ENC differed as a function of maternal education for END. The model-based estimate of FSB risk was reduced among mothers with 0-7 years of education (19.7/1,000 live births pre-ENC, CI: 16.3, 23.0 vs. 12.2/1,000 live births post-ENC, CI: 16.3, 23.0, p < 0.001), but was not significantly different for mothers with ≥8 years of education, respectively. Conclusion: A low level of maternal education was associated with higher risk for FSB and END. ENC training was more effective in reducing FSB among mothers with low education levels.

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