Cited by 83Global Maternal and Child HealthMaternal and Neonatal HealthcareChild Nutrition and Water Access

Effect of Facilitation of Local Maternal-and-Newborn Stakeholder Groups on Neonatal Mortality: Cluster-Randomized Controlled Trial

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Persson, Lars Åke, Nga, Nguyen T., Målqvist, Mats, Thi Phuong Hoa, Dinh, Eriksson, Leif, Wallin, Lars, Selling, Katarina, Huy, Tran Q. +4 more·2013·PLoS Medicine

Abstract

BACKGROUND: Facilitation of local women's groups may reportedly reduce neonatal mortality. It is not known whether facilitation of groups composed of local health care staff and politicians can improve perinatal outcomes. We hypothesised that facilitation of local stakeholder groups would reduce neonatal mortality (primary outcome) and improve maternal, delivery, and newborn care indicators (secondary outcomes) in Quang Ninh province, Vietnam. METHODS AND FINDINGS: In a cluster-randomized design 44 communes were allocated to intervention and 46 to control. Laywomen facilitated monthly meetings during 3 years in groups composed of health care staff and key persons in the communes. A problem-solving approach was employed. Births and neonatal deaths were monitored, and interviews were performed in households of neonatal deaths and of randomly selected surviving infants. A latent period before effect is expected in this type of intervention, but this timeframe was not pre-specified. Neonatal mortality rate (NMR) from July 2008 to June 2011 was 16.5/1,000 (195 deaths per 11,818 live births) in the intervention communes and 18.4/1,000 (194 per 10,559 live births) in control communes (adjusted odds ratio [OR] 0.96 [95% CI 0.73-1.25]). There was a significant downward time trend of NMR in intervention communes (p = 0.003) but not in control communes (p = 0.184). No significant difference in NMR was observed during the first two years (July 2008 to June 2010) while the third year (July 2010 to June 2011) had significantly lower NMR in intervention arm: adjusted OR 0.51 (95% CI 0.30-0.89). Women in intervention communes more frequently attended antenatal care (adjusted OR 2.27 [95% CI 1.07-4.8]). CONCLUSIONS: A randomized facilitation intervention with local stakeholder groups composed of primary care staff and local politicians working for three years with a perinatal problem-solving approach resulted in increased attendance to antenatal care and reduced neonatal mortality after a latent period.

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Authors
Persson, L. Å., Nga, N. T., Målqvist, M., Thi Phuong Hoa, D., Eriksson, L., Wallin, L., Selling, K., Huy, T. Q., Duc, D. M., Tiep, T. V., Thi Thu Thuy, V., & Ewald, U.
Affiliations
  • Uppsala University (SE)
  • Dalarna University (SE)
  • Ministry of Health (VN)
Corresponding author
Persson, Lars Åke
Venue
PLoS Medicine
Published
2013-05-14
Volume
10
Issue
5
Pages
e1001445
ISSN
  • 1549-1277 (ISSN-L)
  • 1549-1676
OpenAlex
W2121089097
Cited by
83
References
38
Citations by year
2026: 3 · 2025: 1 · 2024: 5 · 2023: 9 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 5 · 2018: 11 · 2017: 7 · 2016: 6 · 2015: 12 · 2014: 2 · 2013: 3
FWCI
7.13
Type
journal article
Language
en
Open access
Locations
  • PLoS Medicine (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Dalarna University College Electronic Archive (submittedVersion, other-oa)
  • KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Greater South Information System
Funders
  • Styrelsen för Internationellt Utvecklingssamarbete
  • Vetenskapsrådet
  • Uppsala Universitet
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
  • Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
Keywords
neonatal mortality, stakeholders, community facilitation, problem-solving approach, maternal and newborn care, antenatal care attendance, healthcare workers, local politicians, perinatal outcomes, Quang Ninh province
MeSH terms
Administrative Personnel, Adult, Child Health Services, Community-Institutional Relations, Cooperative Behavior, Female, Health Personnel, Humans, Infant Mortality, Infant, Newborn, Health Knowledge, Attitudes, Practice, Maternal Health Services, Patient Acceptance of Health Care, Pregnancy, Problem Solving, Social Facilitation, Socioeconomic Factors, Time Factors, Vietnam, Odds Ratio, Interdisciplinary Communication, Live Birth, Young Adult

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