Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the Global Network's EmONC trial).
Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the Global Network's EmONC trial).
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DOI：
10.1186/1471-2393-10-82
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发表时间：
2010-12-14
影响因子：
3.1
通讯作者：
Wright LL
中科院分区：
文献类型：
--
作者：
Pasha O;Goldenberg RL;McClure EM;Saleem S;Goudar SS;Althabe F;Patel A;Esamai F;Garces A;Chomba E;Mazariegos M;Kodkany B;Belizan JM;Derman RJ;Hibberd PL;Carlo WA;Liechty EA;Hambidge KM;Buekens P;Wallace D;Howard-Grabman L;Stalls S;Koso-Thomas M;Jobe AH;Wright LL
产妇和新生儿死亡率仍然高得令人无法接受，特别是在大多数分娩发生在家庭环境中或在资源不足的设施中。有几个组织提议提供产科和新生儿紧急护理服务，以改善妊娠结局。然而，产科和新生儿急诊护理服务的有效性从未得到证实。同样未经证实的是，社区动员和社区助产士培训对改善妊娠结局的有效性。我们开发了一项整群随机对照试验，以评估社区动员、助产士培训和改善卫生设施护理质量的综合干预措施对低收入和中等收入国家围产儿死亡率的影响，这些国家的大部分分娩发生在家庭或一级保健设施中。这项试验将在阿根廷、危地马拉、印度、肯尼亚、巴基斯坦和赞比亚的全球妇女和儿童健康研究网络的7个地点的106个分组(每个分组每年300-500次递送)中进行。试行干预措施有三个关键要素：社区动员、社区和助产士的居家救生技能，以及对产科设施的提供者进行培训，以提高护理质量。试验的主要结果是围产儿死亡率。次要结果包括死产率、7天新生儿死亡率、产妇死亡或严重发病率(包括产科瘘、子痫和产科败血症)和28天新生儿死亡率。在这项试验中，我们正在评估包括社区动员和设施培训在内的干预措施的组合，以试图改善妊娠结局。如果成功，这项试验的结果将为政策制定者和临床医生提供重要信息，因为他们试图改善低收入国家孕妇和新生儿的分娩服务。ClinicalTrials.gov NCT01073488
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. 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. 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. ClinicalTrials.gov NCT01073488
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影响因子：
168.9
作者：
Derman, Richard J.;Kodkany, Bhalchandra S.;Moss, Nancy
通讯作者：
Moss, Nancy
影响因子：
158.5
作者：
Jokhio, AH;Winter, HR;Cheng, KK
通讯作者：
Cheng, KK
影响因子：
168.9
作者：
Koblinsky, Marge;Matthews, Zoe;van Lerberghe, Wim
通讯作者：
van Lerberghe, Wim
影响因子：
168.9
作者：
Campbell, Oona M. R.;Graham, Wendy J.
通讯作者：
Graham, Wendy J.
DOI：
10.1111/j.1471-0528.2006.00800.x
发表时间：
2006-02-01
影响因子：
5.8
作者：
Draycott, T;Sibanda, T;Whitelaw, A
通讯作者：
Whitelaw, A