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BMC Pregnancy and Childbirth
Published in: BMC Pregnancy and Childbirth 1/2010

Open Access 01-12-2010 | Study protocol

Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the global network's EmONC trial)

Authors: Omrana Pasha, Robert L Goldenberg, Elizabeth M McClure, Sarah Saleem, Shivaprasad S Goudar, Fernando Althabe, Archana Patel, Fabian Esamai, Ana Garces, Elwyn Chomba, Manolo Mazariegos, Bhala Kodkany, Jose M Belizan, Richard J Derman, Patricia L Hibberd, Waldemar A Carlo, Edward A Liechty, K Michael Michael Hambidge, Pierre Buekens, Dennis Wallace, Lisa Howard-Grabman, Suzanne Stalls, Marion Koso-Thomas, Alan H Jobe, Linda L Wright

Published in: BMC Pregnancy and Childbirth | Issue 1/2010

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Abstract

Background

Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes.

Methods/Design

We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each) across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis) and 28-day neonatal mortality.

Discussion

In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant women and newborns in low-income countries.

Trial Registration

ClinicalTrials.gov NCT01073488
Appendix
Available only for authorised users
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Metadata
Title
Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the global network's EmONC trial)
Authors
Omrana Pasha
Robert L Goldenberg
Elizabeth M McClure
Sarah Saleem
Shivaprasad S Goudar
Fernando Althabe
Archana Patel
Fabian Esamai
Ana Garces
Elwyn Chomba
Manolo Mazariegos
Bhala Kodkany
Jose M Belizan
Richard J Derman
Patricia L Hibberd
Waldemar A Carlo
Edward A Liechty
K Michael Michael Hambidge
Pierre Buekens
Dennis Wallace
Lisa Howard-Grabman
Suzanne Stalls
Marion Koso-Thomas
Alan H Jobe
Linda L Wright
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2010
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-10-82

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