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Background: Provision of essential newborn care at home, rapid identification of illness, and care-seeking by caregivers can prevent neonatal mortality. Mobile technology can connect caregivers with information and healthcare worker advice more rapidly and frequently than healthcare visits. Community health workers (CHWs) are well-suited to deliver such interventions. We developed an interactive short message service (SMS) intervention for neonatal health in Kenya, named CHV-NEO. CHV-NEO sends automated, theory-based, actionable, messages throughout the peripartum period that guide mothers to evaluate maternal and neonatal danger signs and facilitate real-time dialogue with a CHW via SMS. We integrated this intervention into Kenya's national electronic community health information system (eCHIS), which is currently used at scale to support CHW workflow. Methods: The effect of CHV-NEO on clinical and implementation outcomes will be evaluated through a non-blinded cluster randomized controlled trial. Twenty sites across Kisumu County in Western Kenya were randomized 1:1 to provide either the national eCHIS with integrated CHV-NEO messaging (intervention) or standard of care using eCHIS without CHV-NEO (control). We will compare neonatal mortality between arms based on abstracted eCHIS data from 7200 pregnant women. Secondary outcomes include self-reported provision of essential newborn care (appropriate cord care, thermal care, and timely initiation of breastfeeding), knowledge of neonatal danger signs, and care-seeking for neonatal illness, compared between arms based on questionnaires with a subgroup of 2000 women attending study visits at enrollment in pregnancy and 6 weeks postpartum. We will also determine CHV-NEO's effect on CHW workflows and evaluate determinants of intervention acceptability, adoption, and fidelity of use through questionnaires, individual interviews, and messaging data. Discussion: We hypothesize that the CHV-NEO direct-to-client communication strategy can be successfully integrated within existing CHW workflows and infrastructure, improve the provision of at-home essential newborn care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. The intervention's integration into the national eCHIS tool will facilitate rapid scale-up if it is clinically effective and successfully implemented. Trial registration: ClinicalTrials.gov, NCT05187897. The CHV-NEO study was registered on January 12, 2022. [ABSTRACT FROM AUTHOR]

Abstract Background Provision of essential newborn care at home, rapid identification of illness, and care-seeking by caregivers can prevent neonatal mortality. Mobile technology can connect caregivers with information and healthcare worker advice more rapidly and frequently than healthcare visits. Community health workers (CHWs) are well-suited to deliver such interventions. We developed an interactive short message service (SMS) intervention for neonatal health in Kenya, named CHV-NEO. CHV-NEO sends automated, theory-based, actionable, messages throughout the peripartum period that guide mothers to evaluate maternal and neonatal danger signs and facilitate real-time dialogue with a CHW via SMS. We integrated this intervention into Kenya’s national electronic community health information system (eCHIS), which is currently used at scale to support CHW workflow. Methods The effect of CHV-NEO on clinical and implementation outcomes will be evaluated through a non-blinded cluster randomized controlled trial. Twenty sites across Kisumu County in Western Kenya were randomized 1:1 to provide either the national eCHIS with integrated CHV-NEO messaging (intervention) or standard of care using eCHIS without CHV-NEO (control). We will compare neonatal mortality between arms based on abstracted eCHIS data from 7200 pregnant women. Secondary outcomes include self-reported provision of essential newborn care (appropriate cord care, thermal care, and timely initiation of breastfeeding), knowledge of neonatal danger signs, and care-seeking for neonatal illness, compared between arms based on questionnaires with a subgroup of 2000 women attending study visits at enrollment in pregnancy and 6 weeks postpartum. We will also determine CHV-NEO’s effect on CHW workflows and evaluate determinants of intervention acceptability, adoption, and fidelity of use through questionnaires, individual interviews, and messaging data. Discussion We hypothesize that the CHV-NEO direct-to-client communication strategy can be successfully integrated within existing CHW workflows and infrastructure, improve the provision of at-home essential newborn care, increase timely referral of neonatal illness to facilities, and reduce neonatal mortality. The intervention’s integration into the national eCHIS tool will facilitate rapid scale-up if it is clinically effective and successfully implemented. Trial registration ClinicalTrials.gov, NCT05187897 . The CHV-NEO study was registered on January 12, 2022.

Abstract Background The newborn and infant continuum of care such as essential newborn care, early initiation and exclusive breastfeeding, and immunisation are highly recommended for improving the quality of life and survival of infants. However, newborn and infant mortality remains high across Sub-Saharan African countries. While unintended pregnancies are associated with adverse newborn and infant health outcomes, there is inconclusive evidence on whether pregnancy intention influences newborn and infant continuum of care completion. Therefore, this review aimed to pool findings reported in the literature on the association between pregnancy intention and newborn and infant health care across the continuum of care in Sub-Saharan Africa. Methods We searched MEDLINE Complete, EMBASE, CINAHL Complete, and Global Health databases for studies potentially eligible for this systematic review and meta-analysis. Two researchers independently screened the identified articles by abstract and title, and then full-text using Covidence. We used the Newcastle–Ottawa Scale to assess the quality of the included studies. The Cochran’s Q test and I2 were executed to detect and quantify the presence of statistical heterogeneity in the studies. Meta-analysis was done for each outcome when more than one original study reported relevant data, using Stata statistical software version 18. Results Eleven studies were included from a total of 235 articles identified by the search. The odds of completing essential newborn care (pooled odds ratio: 3.04, 95% CI: 1.56, 5.90), early initiation of breastfeeding (pooled odds ratio: 1.30, 95% CI: 1.13, 1.52), exclusive breastfeeding (pooled odds ratio: 2.21, 95% CI: 1.68, 2.89), and being fully immunised (pooled odds ratio: 2.73, 95% CI: 1.16, 6.40) were higher among infants born to women with intended pregnancies as compared to women with unintended pregnancies. Conclusion Intended pregnancy was positively associated with essential newborn care completion, early initiation and exclusive breastfeeding, and full immunisation of infants in SSA countries. Thus, policy-makers and stakeholders should strengthen the provision of quality family planning services to prevent unintended pregnancy. Furthermore, follow-up of women with unintended pregnancies is needed to increase women’s opportunity to access essential newborn health care services that further reduce the risk of newborn and infant morbidity and mortality. Systematic review registration PROSPERO registration number CRD42023409148.

BackgroundPreventing neonatal mortality and morbidity in developing countries such as Ethiopia requires improved practices and knowledge among healthcare providers. Several studies have been conducted in Ethiopia, but the overall level has not been estimated based on essential newborn care practices, knowledge of health care providers, and associated factors. Therefore, the objective of this review is to assess the overall practice and knowledge of essential newborn care and associated factors among healthcare providers in Ethiopia.Methods and materialsOnly articles published in English were included in this review. Medline/PubMed, Web of Science, Google Scholar, EMBASE, and CINAHL, Scopus, Ethiopian University Repository Online, and the Cochrane Library are the main databases. The review included cross-sectional studies written in English that met the inclusion requirements. Using a random-effects model, the overall practice and knowledge level was estimated. Additionally, funnel plots and Eggers’ test were used to assess publication bias. STATA version 14 was used to perform all statistical analysis.ResultsThis review included 15 studies involving 3,210 health care providers in Ethiopia. In Ethiopia, overall health care providers had a good practice and knowledge level of essential newborn care of 57.38% [95% CI (49.56; 65.20); I2 = 95.3%, P

Aim: The aim of the present study was to assess knowledge and practices of postnatal mothers on essential newborn care. Methods: A cross-sectional study was carried out within a community with 100 postnatal moms and their newborns. Approval was obtained from the institute's ethical committee. A birth registration at each sub-centre was consulted to compile a list of postnatal mothers who gave birth during the study period and registered using convenience sampling methods. Results: Participants averaged 25.65 years old with a standard deviation of 3.87. Most postnatal mothers (95%) were Hindu, living in joint families (80%), and housewives (94%). Over 50% of the moms had at least a secondary level education, and most of them were from middle-class or higher socioeconomic origins according to the revised BG Prasad's scale-2019. Babies had an average birth weight of 2906±460.4 grams. The majority of the neonates were second-born (46%) with an average gestational age of 38.62±1.76 weeks. The study included nearly equal numbers of male and female neonates. The majority of newborns (74%), weighed 2500-3499 g. On average, newborns were 19.26±8.72 days old during their mothers' postnatal interviews. The average knowledge scores of postnatal moms on Essential Newborn Care (ENBC) were 24.46±6.74. About 50% of postnatal mothers were moderately knowledgeable. Postnatal mothers in Essential Newborn Care (ENBC) had an average practice score of 22.48±4.06. Over two-thirds of postnatal mothers practiced enough. Conclusion: Most postpartum women were moderately informed and satisfied with Exclusive Nursing and Breastfeeding Counseling. There were safety issues in thermal control, nursing, cord care, and eye care, emphasizing the need for education and debunking myths. [ABSTRACT FROM AUTHOR]

Background: Preventing neonatal mortality and morbidity in developing countries such as Ethiopia requires improved practices and knowledge among healthcare providers. Several studies have been conducted in Ethiopia, but the overall level has not been estimated based on essential newborn care practices, knowledge of health care providers, and associated factors. Therefore, the objective of this review is to assess the overall practice and knowledge of essential newborn care and associated factors among healthcare providers in Ethiopia., Methods and Materials: Only articles published in English were included in this review. Medline/PubMed, Web of Science, Google Scholar, EMBASE, and CINAHL, Scopus, Ethiopian University Repository Online, and the Cochrane Library are the main databases. The review included cross-sectional studies written in English that met the inclusion requirements. Using a random-effects model, the overall practice and knowledge level was estimated. Additionally, funnel plots and Eggers' test were used to assess publication bias. STATA version 14 was used to perform all statistical analysis., Results: This review included 15 studies involving 3,210 health care providers in Ethiopia. In Ethiopia, overall health care providers had a good practice and knowledge level of essential newborn care of 57.38% [95% CI (49.56; 65.20); I 2  = 95.3%, P  < 0.001] and 54.06% [95% CI (45.07; 63.05); I  < 0.001], respectively. Knowledge, training status, and material availability of healthcare professional were significantly associated with their practice of essential newborn care, while educational qualification and training status were significantly associated with the knowledge of healthcare providers of essential newborn care.2  = 95.5%, P  < 0.001], respectively. Knowledge, training status, and material availability of healthcare professional were significantly associated with their practice of essential newborn care, while educational qualification and training status were significantly associated with the knowledge of healthcare providers of essential newborn care., Conclusions: Overall, 57% and 54% of healthcare providers had good ENC practices and knowledge. So, the Ethiopian government and other stakeholders should take immediate measures to improve essential neonatal care practice and knowledge among healthcare providers, and improve identified factors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Geta Hardido, Atinafu Ataro, Elfios, Abuye and Kebede.)

Background . Around half of child deaths that occur before the age of 5 are related to newborn-related causes. The advice on caring for newborns may not always match with local traditions and beliefs. That's why it's important to understand the current newborn care practices and what influences them. This will help implement efforts to reduce newborn deaths. The goal of this research was to assess essential newborn care practices and the factors associated with them among women who have recently given birth. Methods . A community-based cross-sectional study was conducted in Libo Kemekem District from April 1 to May 1, 2021, among 601 women. Face-to-face interviews using a structured questionnaire were employed for data collection. The completeness of the questionnaires was checked, and errors were manually corrected. The data was then entered into EpiData v3.1 and transferred to SPSS v26.0 for analysis. Descriptive statistics were used to calculate frequencies, percentages, means, and standard deviations of the findings. Bivariate and multivariate analyses were performed to assess the association between variables for early newborn care practices (ENCP). In the bivariable models, independent variables that showed a statistically significant relationship at a P -value less than .2 with the outcome variable were considered candidates for the multivariable logistic regression models. In the multivariate regression, a P -value < .05 was considered statistically significant. Results were presented in text, tables, and graphs. Additionally, we checked for multicollinearity and performed the Hosmer and Lemeshow goodness-of-fit test to ensure the validity of the multivariate logistic regression analysis. Result . The study revealed that 54.2% (95% CI, 50%-58%) of mothers practiced comprehensive ENBC. In the multivariable binary logistic regression analysis, several factors were found to be significantly associated with ENBC. Primary education was associated with a reduced likelihood of practicing essential newborn care, with an adjusted odds ratio (AOR) of 0.34 (95% CI: 0.23-0.78). Similarly, secondary education was also associated with a reduced likelihood, with an AOR of 0.51 (95% CI: 0.34-0.89). On the other hand, mass media exposure was associated with an increased likelihood of practicing essential newborn care, with an AOR of 2.03 (95% CI: 1.35-3.07). The number of ANC visits was also a significant factor, with an AOR of 0.403 (95% CI: 0.237-0.686. Furthermore, knowledge about ENBC and newborn danger signs were both important predictors, with AORs of 3.93 (95% CI: 2.09-7.37) and 0.31 (95% CI: 0.12-0.74), respectively. Conclusion . This study reveals a critically low level of essential newborn care practices in the local community, influenced by education, mass media exposure, ANC visits, mothers' knowledge, and awareness of newborn danger signs. Addressing these factors through targeted interventions can reduce neonatal mortality rates, emphasizing the need for investments in education, health literacy programs, and healthcare services to enhance mothers' and newborns' health outcomes., Competing Interests: The author(s) declared no potential conflicts of interest concerning the research, authorship, and/or publication of this article., (© The Author(s) 2024.)