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dc.contributor.authorMazumder, Sarmilaen_US
dc.contributor.authorTaneja, Sunitaen_US
dc.contributor.authorBahl, Rajiven_US
dc.contributor.authorMohan, Pavitraen_US
dc.contributor.authorStrand, Tor A.en_US
dc.contributor.authorSommerfelt, Halvoren_US
dc.contributor.authorKirkwood, Bettyen_US
dc.contributor.authorGoyal, Nidhien_US
dc.contributor.authorVan Den Hombergh, Henrien_US
dc.contributor.authorMartines, Jose Carlosen_US
dc.contributor.authorBhandari, Nitaen_US
dc.date.accessioned2015-10-12T12:42:11Z
dc.date.available2015-10-12T12:42:11Z
dc.date.issued2014-08-29
dc.PublishedBMJ (British Medical Journal) 2014, 349:g4988eng
dc.identifier.issn0959-535X
dc.identifier.urihttps://hdl.handle.net/1956/10562
dc.description.abstractObjective: To determine the effect of implementation of the Integrated Management of Neonatal and Childhood Illness strategy on treatment seeking practices and on neonatal and infant morbidity. Design: Cluster randomised trial. Setting: Haryana, India. Participants: 29 667 births in nine intervention clusters and 30 813 births in nine control clusters. Main outcome measures: The pre-specified outcome was the effect on treatment seeking practices. Post hoc exploratory analyses assessed morbidity, hospital admission, post-neonatal infant care, and nutritional status outcomes. Interventions: The Integrated Management of Neonatal and Childhood Illness intervention included home visits by community health workers, improved case management of sick children, and strengthening of health systems. Outcomes were ascertained through interviews with randomly selected caregivers: 6204, 3073, and 2045 in intervention clusters and 6163, 3048, and 2017 in control clusters at ages 29 days, 6 months, and 12 months, respectively. Results: In the intervention cluster, treatment was sought more often from an appropriate provider for severe neonatal illness (risk ratio 1.76, 95% confidence interval 1.38 to 2.24), for local neonatal infection (4.86, 3.80 to 6.21), and for diarrhoea at 6 months (1.96, 1.38 to 2.79) and 12 months (1.22, 1.06 to 1.42) and pneumonia at 6 months (2.09, 1.31 to 3.33) and 12 months (1.44, 1.00 to 2.08). Intervention mothers reported fewer episodes of severe neonatal illness (risk ratio 0.82, 0.67 to 0.99) and lower prevalence of diarrhoea (0.71, 0.60 to 0.83) and pneumonia (0.73, 0.52 to 1.04) in the two weeks preceding the 6 month interview and of diarrhoea (0.63, 0.49 to 0.80) and pneumonia (0.60, 0.46 to 0.78) in the two weeks preceding the 12 month interview. Infants in the intervention clusters were more likely to still be exclusively breast fed in the sixth month of life (risk ratio 3.19, 2.67 to 3.81). Conclusion: Implementation of the Integrated Management of Neonatal and Childhood Illness programme was associated with timely treatment seeking from appropriate providers and reduced morbidity, a likely explanation for the reduction in mortality observed following implementation of the programme in this study.en_US
dc.language.isoengeng
dc.publisherBMJeng
dc.rightsAttribution CC BY-NCeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc/3.0/eng
dc.titleEffect of implementation of Integrated Management of Neonatal and Childhood Illness programme on treatment seeking practices for morbidities in infants: cluster randomised trialen_US
dc.typePeer reviewed
dc.typeJournal article
dc.date.updated2015-07-29T13:12:41Z
dc.description.versionpublishedVersionen_US
dc.rights.holderCopyright 2014 The Authors
dc.identifier.doihttps://doi.org/10.1136/bmj.g4988
dc.identifier.cristin1152462
dc.relation.projectNorges forskningsråd: 223269


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