Project Lead(s): Shaun Morris
Globally, nearly three million neonatal deaths occurred in 2012 in their first month of life, with about two-thirds of the mortality due to infection, low birth weight (LBW) and prematurity.
Low-tech but high-impact interventions and commodities used in unconventional ways could save hundreds of thousands of newborn lives.
Implemented in Pakistan, this project sought to assess the value of an evidence-based newborn survival kit plus education on its use, delivered by community health workers to women during their third trimester of pregnancy.
The kit includes chlorhexidine to be applied to the umbilical stump; sunflower oil emollient to be applied to the skin; ThermoSpot to identify hypo/hyperthermia; and a Mylar infant sleeve with a non-electric warmer to treat hypothermia.
The project was implemented in about 150 villages in rural Pakistan by project partner Maternal Child Care Trust. More than 5,500 pregnant women were enrolled in the study and about 2,900 newborn kits were delivered.
The study period has been extended because the overall mortality rate in the study (29 per 1,000 live births) was markedly lower than the baseline mortality rate used for a priori estimate of sample size and power (42 per 1,000 live births).
The lower-than-anticipated mortality rate in this study has affected the ability of researchers to measure a statistically significant mortality effect.
The study team has secured new funding to extend the enrolment period and achieve statistical power.
The investigators will remain blinded to the identity of each treatment group until the study extension period ends.
As such, it was not possible to report on the study’s measurable outcomes: the total number of mothers using the kit contents correctly, all-cause neonatal mortality, the incidence of omphalitis and severe infection, cases of hypo- and hyperthermia, the identification of LBW newborns, and health facility usage.
Following evaluation of all study data, the team intends to apply for Phase 2 Transiting To Scale funding. The SickKids-based team has been concurrently trialing a similar intervention, in combination with newborn stimulation, in rural Kenya.
Funds leveraged include $175,725 from UBS Optimus and $84,000 from March of Dimes, for a total of $259,725.
Partnerships have been established between SickKids and Maternova and Baby Hero.