Home visits curb new born deaths - research

Apr 02, 2015

If health workers could visit mothers at home during pregnancy and after birth, it would make a difference in saving the lives of new born babies in Uganda, new research suggests.


By Carol Natukunda

If health workers could visit mothers at home during pregnancy and after birth, it would make a difference in saving the lives of new born babies in Uganda, new research suggests.


The research done by Ugandan scientists from the Makerere University School of Public Health  shows that  linking families and health experts can improve a mother’s behavioural and hygiene practices during pregnancy, childbirth and in the first weeks of life.

Uganda’s infant mortality is estimated at 54 deaths per 1,000 live births, while the under-5 mortality  is at 90 deaths per 1,000 live births, according to the 2011 Uganda Demographic Health Survey.

But evidence published this week as a special issue of the international journal ‘Global Health Action,’ suggests an intervention that would benefit poorest families the most to save their new born babies.

Titled Newborn Health in Uganda, the nine-article special issue, details results of a community randomized trial, carried out in rural eastern Uganda by Ugandan researchers. In partnership with local leaders, they evaluated   the impact of   having a designated member of the village health team visit a mother during pregnancy and the postnatal period at home.

Home visits included promotion of optimal maternal and newborn care tips, encouraging use of routine health facility services; counselling on danger signs for mother and baby; a physical assessment including checking the baby’s temperature, breathing, and weight; and referral to a health facility when needed.

The results demonstrated that these home visits in pregnancy and soon-after delivery were possible to achieve, and that life-saving behaviours could be improved by this interaction.

In a press statement released yesterday,  Dr. Peter Waiswa, one of the researchers, said results proved that harmful behaviors can be altered as a result of the interactions between mothers and the village health team members.

“Breastfeeding practices, skin-to-skin care immediately after birth, delaying a baby’s first bath, and hygienic care of the baby’s umbilical cord stump were higher amongst the families receiving home visits compared to those that did not receive them,” Waiswa explained.

“Importantly, these home visits were pro-poor, with more women in the poorest households, who are at most risk of encountering difficulties in access to care, receiving an early home visit after delivery when compared to the wealthiest families. In Iganga hospital where most births occurred, deaths of mothers and babies during and after births reduced dramatically without lots of additional new resources,” stated Waiswa.

The researchers, however, warned that inadequate funding at district level could impede integration between community and health facility care. Waiswa cited challenges as staff shortages and attrition, lack of drugs and equipment as some of the challenges that were undermining efforts to curb infant immortality.

The study, supported by funding from The Bill and Melinda Gates Foundation through Save the Children’s Saving Newborn Lives program and the Swedish International Development Agency, was the first of its kind to be led and carried out by local researchers in Uganda.  It is designed to address important gaps for care around the time of birth at the community and facility level.

Prof. Joy Lawn of the London School of hygiene & Tropical Medicine expressed hope that the results of the Uganda Newborn Study were important for the African continent in accelerating progress in newborn health. She noted that the story was influenced by the 2005 Lancet neonatal survival series which identified highly cost-effective packages of interventions that could avert more than two-thirds of all newborn deaths.

In an interview with New Vision recently, the director general of health services Dr. Rut Jane Aceng said the health ministry had launched a plan to particularly tackle maternal and infant mortality. She said they would intensify the supply of kits and other medical equipment to the mothers at the grassroots.

Aceng said that the ministry would root for interventions that target the direct causes of maternal and child death.

“We shall target accountability. All districts will have routine health management teams and score cuts. All the district maternal, neonatal and child health initiatives have a mandate to increase accountability. We shall strengthen the links between the district health teams and the communities to reduce maternal and child mortality,” Aceng stated.

 

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