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Impact of Neonatal Resuscitation Capacity Building of Birth Attendants on Stillbirth Rate at Public Health Facilities in Uttar Pradesh, India.

Indian Pediatrics 2019 May 16
OBJECTIVE: To document the impact of neonatal resuscitation capacity building of birth attendants at district and sub-district level on fresh stillbirth within the public health system in India.

DESIGN: An implementation research using pre-post study design.

SETTING: 3 high-infant and neonatal mortality districts (Gonda, Aligarh and Raebareli) of Uttar Pradesh, India.

PARTICIPANTS: Pregnant women who delivered at the health facilities and their newborns.

INTERVENTIONS: An intervention package with (i) training on essential newborn care resuscitation; (ii) skill laboratories establishment for peer-interactive learning; (iii) better documentation; and (iv) supportive supervision was implemented at all health facilities in the districts.

MAIN OUTCOME MEASURES: Impact on fresh stillbirth rates and resuscitation practices were documented at 42 health facilities (Gonda-17, Aligarh-8 and Raebareli-17) over 12-18 months.

RESULTS: Out of the 3.3% (4431/133627) newborns requiring resuscitation, 58.5% (n=2599) were completely revived, 19% (n=842) had some features of hypoxic insult after birth and 1.4% (n=62) were stillbirths. There was 15.6% reduction in still birth rate in the three districts with the intervention package.

CONCLUSIONS: The reduction in still birth rate and improvement in newborn resuscitation efforts in the three districts indicated feasibility of implementation and scalability of the intervention package. However sustenance of the impact over longer period needs documentation.

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