From the World Health Organization (WHO) website.  The interventions include Clean Birth Kits (CBKs). Read on:

WHO study shows community-based health interventions reduce stillbirths and newborn deaths

An article published in the Lancet medical journal on 15 January 2011 shows that boosting community-based health interventions in rural Pakistan produced a significant reduction in stillbirths and newborn deaths. These findings were the result of a study supported by WHO’s Department of Child and Adolescent Health and Development.

The cluster randomized trial conducted between February 2006 and March 2008 in the Hala and Matiari subdistricts utilized the network of lady health workers (LHWs) who are part of the existing government health system in Pakistan. In the study areas, LHWs delivered a package of extra interventions designed to improve newborn survival, in collaboration with traditional birth attendants and voluntary community health committees.

The intervention package delivered by LHWs through group sessions and home visits consisted of promoting antenatal care, facility births and immediate newborn care, maternal health education, use of clean delivery kits, identification of danger signs that could indicate that the baby had a serious illness and promotion of care-seeking if there were signs that the baby may be seriously ill. In the study’s “control” areas, routine care was provided by LHWs and health workers in facilities (i.e. no group activities and no special focus on newborn care).

The low-technology intervention package was shown to reduce stillbirths by 21% and newborn deaths by 15%. Other key findings of the study included:

• Mothers in the intervention areas were more likely to give birth in hospital than mothers in control areas;
• Among those who delivered at home, the use of clean delivery kits was much more common in the intervention clusters (35% vs. 3%); and
• Healthy behaviours were better in intervention areas — e.g. more women started breastfeeding within 30 minutes of giving birth (43% vs. 27%) and delayed bathing the baby beyond 6 hours (50% vs. 27%) which is important for keeping the baby warm.

Dr Elizabeth Mason, Director of the Department of Child and Adolescent Health and Development said “This trial proves that trained community health workers can effectively deliver essential newborn care. This type of training can and should be scaled-up within public sector programmes to save newborn lives.”

WHO is supporting countries to scale-up interventions that reduce maternal, newborn and child mortality in the context of MDGs 4 and 5 and the UN Secretary-General’s Global Strategy for Women’s and Children’s Health. With less than five years remaining to achieve the goals, the scaling-up of public sector programmes such as the one trialled in Hala, Pakistan, is more important now than ever. At the September 2010 launch of the Global Strategy, donors committed more than $40 billion in new funding to accelerate progress towards meeting the goals for maternal and child health by 2015, including specific commitments on scaling-up outreach services to communities.

• Read the Lancet article
• More information about the Global Strategy for Women’s and Children’s Health