College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Global Health, University of Washington, Seattle, Washington, USA.
BMJ Open. 2024 Sep 13;14(9):e081330. doi: 10.1136/bmjopen-2023-081330.
Despite significant progress over past decades, neonatal and infant morbidity and mortality remain unacceptably high in Ethiopia. Simple interventions have been shown to improve the health of children and reduce mortality. These include promotion of exclusive breast feeding for the first 6 months of life, immunisation and utilisation of available newborn healthcare services, which are proven to improve newborn survival. This study aims to determine the impact of a behaviour change intervention that partners Orthodox priests with volunteer community health workers, known in Ethiopia as the Health Development Army and trains them to conduct newborn health outreach to improve care seeking, uptake of key interventions and identification of sick infants.
The study designed is a community-randomised trial conducted in the Central Gondar area. The behaviour change intervention pairs trained Orthodox priests with members of the Health Development Army to conduct community health outreach by identifying near-term pregnant women in their communities and educating them on the topics of exclusive breast feeding, immunisation, nutrition and uptake of available child healthcare services. The evaluation of the intervention will enrol up to 150 newborn-mother pairs from communities receiving the behaviour change intervention and another 150 pairs enrolled from control communities. The quantitative analysis will be done by comparing data between the intervention and control groups related to breast feeding, anthropometry, immunisation status and uptake of child health services. The primary outcomes are exclusive breastfeeding through 6 months, mid-upper arm circumference, completion of vaccinations and infant hospitalisation.
Ethical approval has been obtained from the University of Washington (STUDY00006942) and the University of Gondar (No.V/P/RCS/05/2523/2019) Institutional Review Boards. Oral consent was obtained for the formative study, whereas written consent (or witnessed thumbprint) will be obtained from all enrolled mothers. Results will be communicated to community members, relevant government agencies and other stakeholders.
NCT05111899.
尽管过去几十年取得了重大进展，但在埃塞俄比亚，新生儿和婴儿的发病率和死亡率仍然高得令人无法接受。已证实，一些简单的干预措施可以改善儿童健康状况并降低死亡率。这些干预措施包括在生命的前 6 个月内提倡纯母乳喂养、进行免疫接种以及利用现有的新生儿保健服务，因为这些措施已被证明可以提高新生儿的存活率。本研究旨在确定一种行为改变干预措施的效果，该措施将东正教牧师与志愿社区卫生工作者（在埃塞俄比亚称为卫生发展军）合作，培训他们开展新生儿保健外展活动，以改善寻求护理、接受关键干预措施和识别患病婴儿的情况。
该研究是在中央贡德尔地区进行的一项社区随机试验。行为改变干预措施将经过培训的东正教牧师与卫生发展军成员配对，通过在社区中识别即将分娩的孕妇，并对她们进行有关纯母乳喂养、免疫接种、营养和利用现有儿童保健服务的教育，开展社区卫生外展活动。该干预措施的评估将从接受行为改变干预的社区中招募多达 150 对母婴，从对照社区中招募另外 150 对母婴。将通过比较干预组和对照组之间与母乳喂养、人体测量学、免疫接种状况和儿童保健服务利用率相关的数据来进行定量分析。主要结局指标是通过 6 个月的纯母乳喂养、中上臂围、完成疫苗接种和婴儿住院情况来衡量。
该研究已获得华盛顿大学（STUDY00006942）和贡德尔大学（No.V/P/RCS/05/2523/2019）机构审查委员会的伦理批准。形成性研究获得了口头同意，而所有入组的母亲都将获得书面同意（或见证拇指印）。研究结果将传达给社区成员、相关政府机构和其他利益攸关方。
NCT05111899。
