Table 1. Studies included, analysis of neonatal mortality in six low- and lower-middle-income countries, 2007–2013.
| Characteristic | Study country |
||||||
|---|---|---|---|---|---|---|---|
| Bangladesh | Ghanaa | India | Pakistan (Karachi) | Pakistan (Sindh) | United Republic of Tanzania | Zambia | |
| Study site | Projahnmo area, Sylhet district | 7 rural and semi-urban districts in the Brong-Ahafo Region | 18 rural and semi-urban areas in Haryana State | 4 peri-urban and 1 urban site in Karachi city | Naushahro Feroze, a rural district of Sindh Province | Pemba Island | 45 clusters in Southern Province |
| Approximate population under surveillance, n | 182 000 | 600 000 | 550 000 | 274 000 | 243 000 | 400 000 | NDb |
| Proportion of women who had ≥ 1 antenatal care visit, % | 60 | 97 | 59 | 75 | 78 | 85 | 96 |
| Proportion of women with a skilled birth attendant present at delivery, % | 14 | 64 | 50 | 59 | 56 | 51 | 55 |
| Study period | 2007–2009 | 2008 | 2008–2010 | 2011 | 2010–2012 | 2009–2013 | 2011–2013 |
| Type of study | Cluster randomized trial | Two cluster randomized trials | Cluster randomized trial | Cohort study (Health and Demographic Surveillance system data) | Cluster randomized trial | Individually randomized trial | Cluster randomized trial |
| Intervention | Chlorhexidine applied to the umbilical cord stump | Low-dose vitamin A supplementation for women of reproductive age (ObaapaVitA trial) and home visits by community health workers (Newhints trial) | Implementation of Integrated Management of Neonatal and Childhood Illness programme, which included home visits for early newborn care | No intervention | Intervention package for mothers and babies implemented by traditional birth attendants and lady health workers | Chlorhexidine applied to the umbilical cord stump | Chlorhexidine applied to the umbilical cord stump |
| Identification of pregnancy | Noted during home visits carried out by community health workers every 2-months | Noted during home visits carried out by trained field workers every 4 weeks | Noted during monthly home visits by trained study workers | Noted during home visits carried out by community health workers every 3 months | Noted during home visits carried out by community health workers every 3 months | Noted during weekly contacts with families made by community health workers | Pregnant women enrolled during antenatal visits and community outreach programmes |
| Identification of birth | Noted during a home visit carried out at birth | Noted during home visits carried out by trained field workers every 4 weeks | Noted during monthly home visits by trained study workers or during follow-up visits to pregnant women | Reported by the birth attendant and confirmed by calling the family or noted during a surveillance home visit carried out by a study worker | Reported by the birth attendant and confirmed by calling the family, reported by a lady health worker or village volunteer or noted during a surveillance visit by a study worker | Reported to a central information system by a health worker in the local maternity ward, a maternal and child health worker or a traditional birth attendant | Notified by a staff member at a facility or by a family member at a visit or by phone |
| Identification of neonatal death | Noted during the 6 home visits made during the neonatal period | Noted during the home visit made during the neonatal period or the home visit made after the neonatal period | Noted during the home visit made at the end of the neonatal period on day 29 | Noted during the 6 home visits made during the neonatal period | Noted during the 3 home visits made during the neonatal period or on a quarterly home visit | Noted during the 5 home visits made during the neonatal period | Noted during the 5 home visits made during the neonatal period |
| Groups included in the analysis | Control clusters only | Full trial cohorts | Control clusters only | Full trial cohort | Control clusters only | Full trial cohort | Control clusters only |
ND: not determined.
a For Ghana, data came from a combination of two trials: (i) the ObaapaVitA trial, which collected data between January and October 2008; and (ii) the Newhints trial, which collected data during the preparatory phase in November and December 2008 – the full intervention did not start until June 2009.
b The population covered by the trial in Zambia was not determined because women were enrolled at antenatal clinics or during community outreach.