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Effect of Facilitation of Local Stakeholder Groups on Equity in Neonatal Survival: Results from the NeoKIP Trial in Northern Vietnam.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
Hanoi School of Public Health, Hanoi, Vietnam.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell barnhälsa och nutrition/Persson)
2015 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 10, no 12, e0145510Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: To operationalize the post-MDG agenda, there is a need to evaluate the effects of health interventions on equity. The aim of this study is to evaluate the effect on equity in neonatal survival of the NeoKIP trial (ISRCTN44599712), a population-based, cluster-randomized intervention trial with facilitated local stakeholder groups for improved neonatal survival in Quang Ninh province in northern Vietnam.

METHODS: Semi-structured interviews were conducted with all mothers experiencing neonatal mortality and a random sample of 6% of all mothers with a live birth in the study area during the study period (July 2008-June 2011). Multilevel regression analyses were performed, stratifying mothers according to household wealth, maternal education and mother's ethnicity in order to assess impact on equity in neonatal survival.

FINDINGS: In the last year of study the risk of neonatal death was reduced by 69% among poor mothers in the intervention area as compared to poor mothers in the control area (OR 0.31, 95% CI 0.15-0.66). This pattern was not evident among mothers from non-poor households. Mothers with higher education had a 50% lower risk of neonatal mortality if living in the intervention area during the same time period (OR 0.50, 95% CI 0.28-0.90), whereas no significant effect was detected among mothers with low education.

INTERPRETATION: The NeoKIP intervention promoted equity in neonatal survival based on wealth but increased inequity based on maternal education.

Place, publisher, year, edition, pages
2015. Vol. 10, no 12, e0145510
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:uu:diva-270723DOI: 10.1371/journal.pone.0145510ISI: 000367481900048PubMedID: 26713871OAI: oai:DiVA.org:uu-270723DiVA: diva2:890418
Funder
Sida - Swedish International Development Cooperation Agency
Available from: 2016-01-03 Created: 2016-01-03 Last updated: 2017-12-01Bibliographically approved

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Målqvist, MatsPersson, Lars-ÅkeEkholm Selling, Katarina

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