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Acta Obstet Gynecol Scand. 2012 May;91(5):593-7. doi: 10.1111/j.1600-0412.2012.01374.x. Epub 2012 Mar 29.

Training traditional birth attendants on the WHO Essential Newborn Care reduces perinatal mortality.

Author information

1
IMSALUD, Guatemala City, Guatemala. anagarces@imsalud.org

Abstract

OBJECTIVES:

To evaluate the impact of birth attendant training using the World Health Organization Essential Newborn Care (ENC) course among traditional birth attendants, with a particular emphasis on the effect of acquisition of skills on perinatal outcomes.

DESIGN:

Population-based, prospective, interventional pre-post design study.

SETTING:

11 rural clusters in Chimaltenango, Guatemala.

POPULATION:

Health care providers.

METHODS:

This study analyzed the effect of training and implementation of the ENC health care provider training course between September 2005 and December 2006.

OUTCOME MEASURES:

The primary outcome measure was the rate of death from all causes in the first seven days after birth in fetuses/infants ≥1500g. Secondary outcome measures were overall rate of stillbirth, rate of perinatal death, which included stillbirths plus neonatal deaths in the first seven days in fetuses/infants ≥1500g.

RESULTS:

Perinatal mortality decreased from 39.5/1000 pre-ENC to 26.4 post-ENC (RR 0.72; 95%CI 0.54-0.97). This reduction was attributable almost entirely to a decrease in the stillbirth rate of 21.4/1000 pre-Essential Newborn Care to 7.9/1000 post-ENC (RR 0.40; 95%CI 0.25-0.64). Seven-day neonatal mortality did not decrease (18.3/1000 to 18.6/1000; RR 1.05; 95%CI 0.70-1.57).

CONCLUSION:

Essential Newborn Care training reduced stillbirths in a population-based controlled study with deliveries conducted almost exclusively by traditional birth attendants. Scale-up of this intervention in other settings might help assess reproducibility and sustainability.

PMID:
22324644
PMCID:
PMC4362515
DOI:
10.1111/j.1600-0412.2012.01374.x
[Indexed for MEDLINE]
Free PMC Article

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