Department of Nutrition and Public Health Intervention Research, London School of Hygiene and Tropical Medicine, London WC1E7HT, UK.
Trop Med Int Health. 2013 Aug;18(8):952-61. doi: 10.1111/tmi.12134. Epub 2013 Jun 3.
To evaluate whether the Newhints home visits intervention increased the adoption of skin-to-skin care (SSC), in particular, among low birthweight (LBW) (<2.5 kg) babies.
A cluster-randomised trial, with 49 Newhints zones and 49 control zones, was conducted in seven districts in the Brong Ahafo Region, Ghana. It included all live births between November 2008 and December 2009. In Newhints zones, existing community-based surveillance volunteers were trained to conduct home visits during which they weighed babies and counselled mothers of LBW babies on SSC. Performance of any SSC and SSC for more than 2 h was evaluated.
Of 15,615 live births, 68.5% had recorded birthweights; 10.1% were LBW. Any SSC was 19.4% higher among babies in Newhints vs. control zones (risk ratio, RR: 1.81; 95% confidence interval, CI: 1.40-2.35). Performance of SSC for more than 2 h was, however, low, at only 7.5%, although more than double compared with control zones (RR: 2.72; 95% CI: 1.80-4.10). LBW babies visited and weighed by a volunteer were more likely to receive SSC (PA ny = 0.005; P > 2 h = 0.021), greater for LBW babies, particularly for more than 2 h of SSC (Pinteraction = 0.050).
Newhints successfully promoted the uptake of SSC in rural Ghana. Although findings are encouraging, promotion in rural community settings in sub-Saharan Africa is challenging. Lessons learned can help shape SSC promotion in efforts to increase adoption and save newborn lives.
评估 Newhints 家访干预措施是否增加了皮肤接触护理（SSC）的采用率，特别是在低出生体重（LBW）（<2.5kg）婴儿中。
这是一项在加纳布隆阿哈福地区的 7 个区开展的整群随机试验，共包括 49 个 Newhints 区和 49 个对照区。该研究纳入了 2008 年 11 月至 2009 年 12 月间所有活产儿。在 Newhints 区，利用现有的社区监测志愿者进行家访，家访期间为婴儿称重，并为 LBW 婴儿的母亲提供 SSC 咨询。评估任何 SSC 和 SSC 超过 2 小时的实施情况。
在 15615 例活产儿中，有 68.5%记录了出生体重；10.1%为 LBW。与对照组相比，Newhints 区的任何 SSC 发生率均高出 19.4%（风险比，RR：1.81；95%置信区间，CI：1.40-2.35）。然而，超过 2 小时的 SSC 实施率较低，仅为 7.5%，尽管与对照组相比，这一比例增加了一倍以上（RR：2.72；95% CI：1.80-4.10）。由志愿者访视和称重的 LBW 婴儿更有可能接受 SSC（PA ny = 0.005；P > 2 h = 0.021），对于 LBW 婴儿，特别是超过 2 小时的 SSC，这一比例更大（Pinteraction = 0.050）。
Newhints 成功地促进了加纳农村地区 SSC 的采用。尽管结果令人鼓舞，但在撒哈拉以南非洲的农村社区环境中推广仍面临挑战。吸取的经验教训可以帮助塑造 SSC 的推广，以增加其采用率并拯救新生儿的生命。
