High Compliance with Newborn Community-to-Facility Referral in Eastern: An Opportunity to Improve Newborn Survival
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Date
2013
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
Seventy-five percent of newborn deaths happen in the first-week of life, with the highest risk of death
in the first 24-hours after birth.WHO and UNICEF recommend home-visits for babies in the first-week of life to assess
for danger-signs and counsel caretakers for immediate referral of sick newborns. We assessed timely compliance
with newborn referrals made by community-health workers (CHWs), and its determinants in Iganga and Mayuge
Districts in rural eastern Uganda.
Methods: A historical cohort study design was used to retrospectively follow up newborns referred to health facilities
between September 2009 and August 2011. Timely compliance was defined as caretakers of newborns complying
with CHWs’ referral advice within 24-hours.
Results: A total of 724 newborns were referred by CHWs of whom 700 were successfully traced. Of the 700
newborns, 373 (53%) were referred for immunization and postnatal-care, and 327 (47%) because of a danger-sign.
Overall, 439 (63%) complied, and of the 327 sick newborns, 243 (74%) caretakers complied with the referrals.
Predictors of referral compliance were; the newborn being sick at the time of referral- Adjusted Odds Ratio (AOR) =
2.3, and 95% Confidence-Interval (CI) of [1.6 - 3.5]), the CHW making a reminder visit to the referred newborn shortly
after referral (AOR =1.7; 95% CI: [1.2 -2.7]); and age of mother (25-29) and (30-34) years, (AOR =0.4; 95% CI: [0.2 -
0.8]) and (AOR = 0.4; 95% CI: [0.2 - 0.8]) respectively.
Conclusion: Caretakers’ newborn referral compliance was high in this setting. The newborn being sick, being born
to a younger mother and a reminder visit by the CHW to a referred newborn were predictors of newborn referral
compliance. Integration of CHWs into maternal and newborn care programs has the potential to increase care
seeking for newborns, which may contribute to reduction of newborn mortality.
Description
Keywords
Newborn Community-to-Facility Referral, Eastern Uganda, Newborn Survival
Citation
Nalwadda CK, Waiswa P, Kiguli J, Namazzi G, Namutamba S, et al. (2013) High Compliance with Newborn Community-to-Facility Referral in Eastern Uganda:.An Opportunity to Improve Newborn Survival. PLoS ONE 8(11): e81610. doi:10.1371/journal.pone.0081610