Abstract
BackgroundThere has been little success in attempts to reduce the proportion of births with low birth weight (LBW). However, deaths associated with LBW may be prevented with extra attention to warmth, feeding, and prevention or early treatment of infections. There are few studies on this in Nepal and in many other developing countries. This is a cohort study to evaluate the risk of deaths among LBW infants who received FCHV follow up visit for home-based care compared to those who did not receive in Rural Nepal.MethodsA cohort study design was used with data from the Morang Innovative Neonatal Intervention (MINI) program in Nepal. Relative Risk (RR) is calculated to compare LBW neonates who received FCHV follow up visit as compared to LBW neonates who did not receive visit.ResultsOut of 51,853 newborn infants recorded in the MINI database, 2229 LBW neonates were included in the analysis. The proportion of deaths among those who received FCHV follow up visit and those who did not receive were 2% (95% CI: 1%; 2%) and 11% (95% CI: 6%; 18%) respectively(P < 0.001). The relative risk of death in LBW infants who received FCHV follow up visit was 84% less as compared to LBW infants who did not receive (RR = 0·16; 95% CI: 0·09, 0·29).ConclusionThe current study indicates that to save the lives of LBW young infants simple home-based measures implemented through trained health volunteers within the existing government health system may be effective when technically more sophisticated measures such as tertiary health centers, pediatricians, and expensive technology are limited.
Highlights
There has been little success in attempts to reduce the proportion of births with low birth weight (LBW)
This study explores the impact of community based management of LBW infants on mortality within two months of age, by mobilizing Female Community Health Volunteers (FCHVs) from the Morang Innovative Neonatal Intervention (MINI) program, a prospective cohort study from Nepal
Among 20,044 live births visited by FCHVs within three days, 17,462 had normal weight, 2103 had low birth weight, 327 had very low birth weight and 152 did not have any information on birth weight
Summary
There has been little success in attempts to reduce the proportion of births with low birth weight (LBW). Deaths associated with LBW may be prevented with extra attention to warmth, feeding, and prevention or early treatment of infections. There has been little success in the attempts to reduce the proportion of LBW births [8]. Deaths from LBW can be prevented with extra attention to warmth, feeding, and prevention or early treatment of infections [9,10,11]. An earlier study in Pune, India revealed that home-based management of neonates with LBW or preterm birth, babies with asphyxia, feeding problems or illness achieved a 25% reduction in neonatal mortality by providing advice on keeping the baby warm, exclusive breast-feeding and minimum handling of the baby [13]
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