Table 3.
Comparison of Correct Classification of Newborn Conditions by CHWs using Paper Forms (pCNCP) and mobile-CNCP (mCNCP)
| Danger Signs | Correctly Classified by pCNCP | Correctly Classified by mCNCP | % Pt Diff (mCNCP - pCNCP) | Chi Square Test P-Value | OR | CI for OR | Logit P-Value |
|---|---|---|---|---|---|---|---|
| Low birth-weighta* | 43/84 (51.2%) | 82/86 (95.4%) | 44.2 | < 0.001 | 19.5 | (7.9, 48.1) | < 0.001 |
| Smallb* | 48/84 (57.1%) | 83/86 (96.5%) | 39.4 | < 0.001 | 20.8 | (7.1, 60.8) | < 0.001 |
| Birth-weight or Current Weight < 1500 g* | 70/84 (83.3%) | 85/86 (98.8%) | 15.5 | < 0.001 | 17.0 | (1.8, 160.7) | 0.013 |
| Severe Weight Lossc* | 57/84 (67.9%) | 83/86 (96.5%) | 28.6 | < 0.001 | 13.1 | (4.6, 37.5) | < 0.001 |
| Moderate Weight Lossd* | 56/84 (66.7%) | 83/86 (96.5%) | 29.8 | < 0.001 | 13.8 | (7.3, 26.1) | < 0.001 |
| Poor Movement: Unconscious or moves ONLY when Stimulated | 53/84 (63.1%) | 79/86 (91.9%) | 28.8 | < 0.001 | 6.6 | (2.3, 19.3) | 0.001 |
| History of Convulsions | 68/84 (81.0%) | 70/86 (81.4%) | 0.4 | 0.94 | 1.0 | (0.3, 3.3) | 0.96 |
| Poor Feeding: Unable to feed OR Stopped feeding well | 59/84 (70.2%) | 65/86 (75.6%) | 5.4 | 0.43 | 1.3 | (0.5, 3.2) | 0.56 |
| Severe Chest In-drawing | 74/84 (88.1%) | 68/86 (79.1%) | −9.0 | 0.11 | 0.5 | (0.2, 1.5) | 0.22 |
| Fast Breathinge* | 71/84 (84.5%) | 73/86 (84.9%) | 0.4 | 0.95 | 1.0 | (0.5, 2.0) | 0.94 |
| Umbilicus: red or pus | 69/84 (82.1%) | 61/86 (70.9%) | −11.2 | 0.09 | 0.5 | (0.2, 1.6) | 0.25 |
| Skin Pustules | 82/84 (97.6%) | 80/86 (93.0%) | −4.6 | 0.16 | 0.3 | (0.1, 1.5) | 0.15 |
| Jaundice on Soles or Body | 69/84 (82.1%) | 57/86 (66.3%) | −15.8 | 0.018 | 0.4 | (0.2, 1.1) | 0.08 |
| Eye infection | 82/84 (97.6%) | 81/86 (94.2%) | −3.4 | 0.26 | 0.4 | (0.1, 2.2) | 0.29 |
| Feverf* | 68/84 (81.0%) | 83/86 (96.5%) | 15.5 | 0.001 | 6.5 | (1.3, 31.9) | 0.021 |
| Hypothermia g* | 62/84 (73.8%) | 84/86 (97.7%) | 23.9 | < 0.001 | 14.9 | (2.7, 82.2) | 0.002 |
| Feeding Intoleranceh | 63/84 (75.0%) | 74/86 (86.1%) | 11.1 | 0.07 | 2.1 | (1.3, 3.3) | 0.003 |
| Problems with breastfeedingi | 46/84 (54.8%) | 62/86 (72.1%) | 17.3 | 0.019 | 2.1 | (0.9, 4.9) | 0.07 |
aBirth-weight < 2500 g; bBirth-weight < 2500 g or foot- length < 74 mm; cWeight loss > 10% for small infant or > 15% for non-small infant; dWeight loss is 8–10% for small infant or 10–15% for non-small infant; eRespiratory rate > 60 breaths per min; fTemperature > 38 °C or 100.4 °F; gTemperature < 35.5 °C or 95.9 °F; hInfant has at least one condition: chokes, turns blue or pale when feeding, vomits frequently, has distended or tender abdomen, or bloody stools.; iInfant has problems with at least one: waking easily for feeds, breastfeeding for 10+ minutes for per side, sleeping comfortably between feeds, having 5+ wet diapers per day, mother’s breasts haven’t softened.; OR Odds ratio, CI Confidence interval; *For mCNCP, these danger signs were identified by the built-in algorithms based on guideline thresholds and CHW assessment responses.; Of the 170 assessments performed on 82 unique infants, 84 assessments were conducted by CHWs using pCNCP and 86 assessments were conducted by CHWs using mCNCP. Expert classifcations were gold standard assessors' determiniations of danger signs (present or not present) using mCNCP. CHWs' assessments were considered correct if their classification of individual danger signs were the same as the gold standard assessment of the newborn's condition