Community-based Health Workers Achieve High Coverage in Neonatal Intervention Trials: A Case Study from Sylhet, Bangladesh

Authors

  • Rasheduzzaman Shah ICDDR,B, Mohakhali, Dhaka and Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
  • Melinda K Munos Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
  • Peter J Winch Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
  • Luke C Mullany Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore
  • Ishtiaq Mannan Save the Children-USA, Bangladesh Country Office, Dhaka
  • Syed Moshifiqur Rahman ICDDR,B, Mohakhali, Dhaka
  • Radwanur Rahman ICDDR,B, Mohakhali, Dhaka
  • Daniel Hossain ICDDR,B, Mohakhali, Dhaka
  • Shams El Arifeen ICDDR,B, Mohakhali, Dhaka
  • Abdullah H Baqui Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore

DOI:

https://doi.org/10.3329/jhpn.v28i6.6610

Keywords:

Chlorhexidine, Cluster-randomized trial, Community-based studies, Community health workers, Interventions, Neonatal health, Umbilical cord cleansing, Bangladesh

Abstract

A large proportion of four million neonatal deaths occur each year during the first 24 hours of life. Research is particularly needed to determine the efficacy of interventions during the first 24 hours. Large cadres of community-based workers are required in newborn-care research both to deliver these interventions in a standardized manner in the home and to measure the outcomes of the study. In a large-scale com­munity-based efficacy trial of chlorhexidine for cleansing the cord in north-eastern rural Bangladesh, a two-tiered system of community-based workers was established to deliver a package of essential maternal and newborn-care interventions and one of three umbilical cord-care regimens. At any given time, the trial employed approximately 133 community health workers—each responsible for 4-5 village health work­ers and a population of approximately 4,000. Over the entire trial period, 29,760 neonates were enrolled, and 87% of them received the intervention (their assigned cord-care regimen) within 24 hours of birth. Approaches to recruitment, training, and supervision in the study are described. Key lessons included the importance of supportive processes for community-based workers, including a strong training and field supervisory system, community acceptance of the study, consideration of the setting, study objectives, and human resources available.

Key words: Chlorhexidine; Cluster-randomized trial; Community-based studies; Community health workers; Interventions; Neonatal health; Umbilical cord cleansing; Bangladesh

DOI: 10.3329/jhpn.v28i6.6610

J HEALTH POPUL NUTR 2010 Dec;28(6):610-618

Downloads

Download data is not yet available.
Abstract
906
PDF
587

Downloads

How to Cite

Shah, R., Munos, M. K., Winch, P. J., Mullany, L. C., Mannan, I., Rahman, S. M., Rahman, R., Hossain, D., El Arifeen, S., & Baqui, A. H. (2010). Community-based Health Workers Achieve High Coverage in Neonatal Intervention Trials: A Case Study from Sylhet, Bangladesh. Journal of Health, Population and Nutrition, 28(6), 610–618. https://doi.org/10.3329/jhpn.v28i6.6610

Issue

Section

Original Papers