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Secular trend, seasonality and effects of a community-based intervention on neonatal mortality: follow-up of a cluster-randomised trial in Quang Ninh province, Vietnam
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap.
Research Institute for Child Health, Hanoi, Vietnam.
Hanoi University of Public Health, Vietnam.
Hanoi University of Public Health, Vietnam.
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2018 (Engelska)Ingår i: Journal of Epidemiology and Community Health, ISSN 0143-005X, E-ISSN 1470-2738, Vol. 72, nr 9, s. 776-782Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Background: Little is know about whether the effects of community engagement interventions for child survival in low-income and middle-income settings are sustained. Seasonal variation and secular trend may blur the data. Neonatal mortality was reduced in a cluster-randomised trial in Vietnam where laywomen facilitated groups composed of local stakeholders employing a problem-solving approach for 3 years. In this analysis, we aim at disentangling the secular trend, the seasonal variation and the effect of the intervention on neonatal mortality during and after the trial.

Methods: In Quang Ninh province, 44 communes were allocated to intervention and 46 to control. Births and neonatal deaths were assessed in a baseline survey in 2005, monitored during the trial in 2008–2011 and followed up by a survey in 2014. Time series analyses were performed on monthly neonatal mortality data.

Results: There were 30 187 live births and 480 neonatal deaths. The intervention reduced the neonatal mortality from 19.1 to 11.6 per 1000 live births. The reduction was sustained 3 years after the trial. The control areas reached a similar level at the time of follow-up. Time series decomposition analysis revealed a downward trend in the intervention areas during the trial that was not found in the control areas. Neonatal mortality peaked in the hot and wet summers.

Conclusions: A community engagement intervention resulted in a lower neonatal mortality rate that was sustained but not further reduced after the end of the trial. When decomposing time series of neonatal mortality, a clear downward trend was demonstrated in intervention but not in control areas.

Trial registration number: ISRCTN44599712, Post-results.

Ort, förlag, år, upplaga, sidor
2018. Vol. 72, nr 9, s. 776-782
Nationell ämneskategori
Medicin och hälsovetenskap
Forskningsämne
Internationell hälsa; Epidemiologi; Pediatrik
Identifikatorer
URN: urn:nbn:se:uu:diva-365036DOI: 10.1136/jech-2017-209252ISI: 000445084200004PubMedID: 29764902OAI: oai:DiVA.org:uu-365036DiVA, id: diva2:1261637
Forskningsfinansiär
Vetenskapsrådet, 348-20136546Tillgänglig från: 2018-11-08 Skapad: 2018-11-08 Senast uppdaterad: 2018-11-28Bibliografiskt granskad

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Eriksson, LeifBergström, AnnaMålqvist, MatsEwald, UwePersson, Lars-ÅkeEkholm Selling, Katarina

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Eriksson, LeifBergström, AnnaMålqvist, MatsEwald, UwePersson, Lars-ÅkeEkholm Selling, Katarina
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Internationell mödra- och barnhälsovård (IMCH)VårdvetenskapInternationell barnhälsa och nutrition
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