基于社区的行为变化管理对新生儿死亡率的影响在印度北方邦的Shivgarh:一个集群随机对照试验
Vishwajeet Kumar1, Saroj Mohanty, Aarti Kumar
1International Center for Advancing Neonatal Health, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Lancet (London, England)
|October 18, 2008
概括
通过改善基本的新生儿护理实践,以社区为基础的干预显著降低了印度农村的新生儿死亡率. 这种方法表明了实质性的行为修改,可以应用于连续护理计划.
科学领域:
- 公共卫生 公共卫生
- 孕产妇和儿童的健康
- 全球健康 全球健康
背景情况:
- 在印度农村,家庭分娩很常见,新生儿护理的高风险做法普遍存在.
- 新生儿死亡率在这些环境中仍然是一个重大挑战.
- 开发了一项干预措施,以解决低温症的预防和修改新生儿护理实践.
研究的目的:
- 评估行为改变干预措施在降低新生儿死亡率方面的有效性.
- 评估基本新生儿护理 (ENC) 和ENC以及低温指标 (ThermoSpot) 对新生儿护理实践和死亡率的影响.
- 确定基于社区的方法在印度农村环境中的有效性.
主要方法:
- 一个集群随机对照试验在印度北方邦农村的Shivgarh进行.
- 39个村庄单位被分配给一个对照组,一个ENC干预组或一个ENC加热点干预组.
- 社区卫生工作者通过会议和家庭访问提供干预措施;结果包括实践变化和新生儿死亡率.
主要成果:
- 干预组在分娩准备,卫生分娩,热护理 (包括皮肤护理),带护理,皮肤护理和母乳养方面有所改善.
- 与对照组相比,新生儿死亡率在ENC组下降了54%,在ENC加ThermoSpot组下降了52%.
- 在寻求护理行为中观察到的变化很小.
结论:
- 针对高风险新生儿护理实践的社会文化定制,基于社区的干预措施可以显著改变行为.
- 这种干预模式有效地减少了印度农村的新生儿死亡率.
- 该方法适用于整个护理连续的行为变化,并可以建立社区可持续发展的能力.
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