Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Centre for Global Child Health, The Hospital for Sick Children, Toronto, Ontario, Canada.
BMJ Open. 2020 Jul 14;10(7):e036293. doi: 10.1136/bmjopen-2019-036293.
Pakistan has a high burden of maternal, newborn and child morbidity and mortality. Several factors including weak scale-up of evidence-based interventions within the existing health system; lack of community awareness regarding health conditions; and poverty contribute to poor outcomes. Deaths and morbidity are largely preventable if a combination of community and facility-based interventions are rolled out at scale.
Umeed-e-Nau (UeN) (New Hope) project aims is to improve maternal, newborn and child health (MNCH) in eight high-burden districts of Pakistan by scaling up of evidence-based interventions. The project will assess interventions focused on, first, improving the quality of MNCH care at primary level and secondary level. Second, interventions targeting demand generation such as community mobilisation, creating awareness of healthy practices and expanding coverage of outreach services will be evaluated. Third, we will also evaluate interventions targeting the improvement in quality of routine health information and promotion of use of the data for decision-making. Hypothesis of the project is that roll out of evidence-based interventions at scale will lead to at least 20% reduction in perinatal mortality and 30% decrease in diarrhoea and pneumonia case fatality in the target districts whereas two intervention groups will serve as internal controls. Monitoring and evaluation of the programme will be undertaken through conducting periodical population level surveys and quality of care assessments. Descriptive and multivariate analytical methods will be used for assessing the association between different factors, and difference in difference estimates will be used to assess the impact of the intervention on outcomes.
The ethics approval was obtained from the Aga Khan University Ethics Review Committee. The findings of the project will be shared with relevant stakeholders and disseminated through open access peer-reviewed journal articles.
NCT04184544; Pre-results.
巴基斯坦的孕产妇、新生儿和儿童发病率和死亡率居高不下。一些因素导致了这一结果，包括现有卫生系统中基于证据的干预措施扩展不力；社区对健康状况缺乏认识；以及贫困。如果大规模推出一系列社区和医疗机构干预措施，大部分死亡和发病是可以预防的。
Umeed-e-Nau（UeN）（新希望）项目旨在通过扩大基于证据的干预措施，改善巴基斯坦 8 个高负担地区的孕产妇、新生儿和儿童健康（MNCH）。该项目将评估侧重于以下方面的干预措施：第一，提高基层和二级医疗保健的 MNCH 护理质量；第二，针对需求产生的干预措施，如社区动员、宣传健康实践和扩大外联服务覆盖范围，将进行评估；第三，我们还将评估针对改善常规卫生信息质量和促进数据用于决策的干预措施。该项目的假设是，大规模推出基于证据的干预措施将导致目标地区围产期死亡率降低至少 20%，腹泻和肺炎病死率降低 30%，而两个干预组将作为内部对照。将通过定期进行人口水平调查和护理质量评估来监测和评估该项目。将使用描述性和多变量分析方法来评估不同因素之间的关联，以及差异中的差异估计值将用于评估干预措施对结果的影响。
该项目已获得 Aga Khan 大学伦理审查委员会的批准。项目的研究结果将与相关利益攸关方分享，并通过开放获取的同行评议期刊文章进行传播。
NCT04184544；预结果。
