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Accelerating newborn survival in Ghana through a low-dose, high-frequency health worker training approach: a cluster randomized trial

Journal Article
(Published March, 2018)
Gomez, P. (Author),
Nelson, A. (Author),
Asiedu, A. (Author),
Addo, E. (Author),
Agbodza, D. (Author),
Allen, C. (Author)
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Newborn deaths comprise nearly half of under-5 deaths in Ghana, despite the fact that skilled birth attendants (SBAs) are present at 68% of births, which implies that evidence-based care during labor, birth and the immediate postnatal period may be deficient. We assessed the effect of a low-dose, high-frequency (LDHF) training approach on long-term evidence-based skill retention among SBAs and impact on adverse birth outcomes. METHODS: From 2014 to 2017, we conducted a cluster-randomized trial in 40 hospitals in Ghana. Eligible hospitals were stratified by region and randomly assigned to one of four implementation waves. We assessed the relative risks (RRs) of institutional intrapartum stillbirths and 24-h newborn mortality in months 1-6 and 7-12 of implementation as compared to the historical control period, and in post-intervention facilities compared to pre-intervention facilities during the same period. All SBAs providing labor and delivery care were invited to enroll; their knowledge and skills were assessed pre- and post-training, and 1 year later. RESULTS: Adjusting for region and health facility type, the RR of 24-h newborn mortality in the 40 enrolled hospitals was 0.41 (95% CI 0.32-0.51; p

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Citation: 
Gomez PP, Nelson AR, Asiedu A, Addo E, Agbodza D, Allen C, et al. Accelerating newborn survival in Ghana through a low-dose, high-frequency health worker training approach: a cluster randomized trial. BMC pregnancy and childbirth. 2018;18.