Impact of the Integrated Management of Neonatal and Childhood Illness Strategy on Neonatal and Infant Mortality (IMNCI-India)
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Purpose
This study is a cluster-randomized trial being conducted in the state of Haryana in North India. Eighteen geographical areas served by Primary Health Centres (PHCs) have been randomized to intervention or comparison areas. In the intervention areas, all physicians, health workers and ICDS workers are being trained in the IMNCI. Each of these clusters has an approximate population of 30,000.
The IMNCI intervention includes three main components:
- improvement in the case management skills of health staff
- improvement in the overall health system to support its performance, and
improvement in family and community health care practices which include:
- prevention and management of hypothermia
- early initiation of breastfeeding and exclusive breastfeeding
- community-based care of low birth weight infants
- improved care-seeking for neonatal infections
The primary outcome measures of the study are neonatal and infant mortality. The study will also collect information on cause-specific neonatal mortality, ascertained using a standardized previously validated verbal autopsy instrument administered by trained, skilled health workers. All the other outcomes (including initiation of breastfeeding within 1 hour of birth; Exclusive breastfeeding at 4 weeks of age; Proportion of neonates identified to be sick by caregivers who sought care) are secondary outcomes.
The effectiveness of this comprehensive intervention will be measured by comparing the primary and secondary outcome measures in the intervention and comparison clusters, controlling for any baseline differences such as the predefined outcomes and/or socioeconomic status and demography.
The project will serve as a guide to the Government of India of how to best implement the IMNCI strategy and measure its impact.
| Condition | Intervention |
|---|---|
|
Mortality |
Behavioral: IMNCI |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Health Services Research |
| Official Title: | Impact of the Integrated Management of Neonatal and Childhood Illness Strategy on Neonatal and Infant Mortality in Haryana, India |
- Post day 1 Neonatal mortality (birth to 28 days of age) in the communities receiving the intervention(cohort of infants born to women identified through pregnancy surveillance) [ Time Frame: Over 30 Months ] [ Designated as safety issue: No ]
- Neonatal mortality (from birth to 28 days of age) in the cohort identified through pregnancy surveillance [ Time Frame: Over 30 Months ] [ Designated as safety issue: No ]
- Post day 1 neonatal mortality (1 to 28 days of age) in the population of newborns who are more likely to have greater impact from the intervention i.e. those born at home and available in the study area within 7 days of birth [ Time Frame: 30 months ] [ Designated as safety issue: No ]
- Neonatal mortality (from birth to 28 days of age) in the population more likely to benefit from the intervention [ Time Frame: 30 months ] [ Designated as safety issue: No ]
- Infant mortality (birth to 365 days) in the communities receiving the intervention. [ Time Frame: 30 months ] [ Designated as safety issue: No ]
- Population coverage of key behaviours and interventions [ Time Frame: Over 30 Months ] [ Designated as safety issue: No ]
- Process of intervention delivery in a randomly selected subsample of activities [ Time Frame: Over 30 Months ] [ Designated as safety issue: No ]
| Enrollment: | 66600 |
| Study Start Date: | June 2006 |
| Study Completion Date: | April 2010 |
| Primary Completion Date: | April 2010 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: 1
IMNCI
|
Behavioral: IMNCI
Implementation of IMNCI in the intervention sites
|
|
No Intervention: 2
Control
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | up to 12 Months |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- All births
Exclusion Criteria:
- None
Contacts and Locations| India | |
| Society for Applied Studies | |
| New Delhi, Delhi, India, 110016 | |
| Principal Investigator: | Nita Bhandari, MD, PhD | Society for Applied Studies |
More Information
Publications:
| Responsible Party: | NBhandari, Director, Society for Applied Studies |
| ClinicalTrials.gov Identifier: | NCT00474981 History of Changes |
| Other Study ID Numbers: | C6-181-505 |
| Study First Received: | May 16, 2007 |
| Last Updated: | April 2, 2012 |
| Health Authority: | India: Ministry of Health |
Keywords provided by Society for Applied Studies:
|
neonatal mortality infant mortality newborn caring practices |
ClinicalTrials.gov processed this record on May 23, 2013