Gitaka Jesse, Natecho Alice, Mwambeo Humphrey M, Gatungu Daniel Maina, Githanga David, Abuya Timothy
Research and Innovation Centre, Mount Kenya University, P.O. Box 342-01000, Thika, Kenya.
Fountain Africa Trust, P.O. Box 1632-50205, Webuye, Bungoma, Kenya.
BMC Health Serv Res. 2018 Jun 25;18(1):493. doi: 10.1186/s12913-018-3293-5.
Neonatal mortality is a major health burden in Bungoma County with the rate estimated at 31 per 1000 live births and is above the national average of 22 per 1000. Nonetheless, out of the nine sub county hospitals, only two are fairly equipped with necessary infrastructure and skilled personnel to manage neonatal complications such as prematurity, neonatal sepsis, neonatal jaundice, birth asphyxia and respiratory distress syndrome. Additionally, with more than 50% of neonates delivered without skilled attendance, in below par hygiene environments such as home and on the roadsides, with non-existent community based referral system, the situation is made worse. The study aims to evaluate the progress made by an intervention "Collaborative Newborn Support Project" geared towards reducing neonatal mortality rate by 30% between October 2015 and December 2018 in Bungoma County, Kenya.
METHODS/DESIGN: This intervention will take a quasi-experimental design approach with experimental and control sites. The project will involve pre- and post-intervention data collection with comparison group to assess intervention effects. The primary outcome will be the percentage reduction of neonatal mortality in Bungoma County. Secondary outcomes include; a) Percentage of mothers or care givers able to identify at least three danger signs in neonates in the project area, b) Proportion of neonates with complications referred to specialized neonatal centers, through the call center, c) Percentage of health providers in neonatal care units who adhere to expected neonatal standards of care (rapid and complete application of standard protocols), d) Percentage increase in neonates with severe complications in the specialized neonatal units and e) Percentage of neonates who stay in neonatal care units beyond 5 days.
We outline implementation details of the ongoing 'Collaborative Newborn Support Project' in Bungoma County, Kenya. This includes strategies in the operations of the telehealth platform, call centre service, community engagement and measuring of the outputs and outcomes. The funding and ethical approvals have been obtained and the study commenced.
PACTR201712002802638 Retrospectively registered on 5th December 2017 at Pan African Clinical Trials Registry.
在邦戈马县，新生儿死亡率是一项重大的健康负担，估计每1000例活产中有31例死亡，高于全国每1000例22例的平均水平。然而，在九个次级县医院中，只有两家配备了较为完善的必要基础设施和专业人员，以处理早产、新生儿败血症、新生儿黄疸、出生窒息和呼吸窘迫综合征等新生儿并发症。此外，超过50%的新生儿在缺乏专业医护人员照料的情况下出生，分娩环境不佳，如家中和路边，且缺乏社区转诊系统，这使得情况更加糟糕。该研究旨在评估一项名为“新生儿协作支持项目”的干预措施所取得的进展，该项目旨在2015年10月至2018年12月期间，在肯尼亚邦戈马县将新生儿死亡率降低30%。
方法/设计：本干预措施将采用准实验设计方法，设有实验组和对照组。该项目将在干预前后收集数据，并与对照组进行比较，以评估干预效果。主要结果将是邦戈马县新生儿死亡率降低的百分比。次要结果包括：a）项目地区能够识别至少三种新生儿危险信号的母亲或护理人员的百分比；b）通过呼叫中心转诊至专业新生儿中心的并发症新生儿比例；c）新生儿护理单位中遵守预期新生儿护理标准（快速并完整应用标准方案）的医护人员百分比；d）专业新生儿单位中严重并发症新生儿增加的百分比；e）在新生儿护理单位住院超过5天的新生儿百分比。
我们概述了肯尼亚邦戈马县正在进行的“新生儿协作支持项目”的实施细节。这包括远程医疗平台运营、呼叫中心服务、社区参与以及产出和结果衡量等方面的策略。该项目已获得资金和伦理批准，研究已开始。
PACTR201712002802638于2017年12月5日在泛非临床试验注册中心进行回顾性注册。
