JoVE Visualize What is visualize?
Stop Reading. Start Watching.
Advanced Search
Stop Reading. Start Watching.
Regular Search
Find video protocols related to scientific articles indexed in Pubmed.
Etiology of Bacteremia in Young Infants in Six Countries.
Pediatr. Infect. Dis. J.
PUBLISHED: 11-13-2014
Show Abstract
Hide Abstract
Neonatal illness is a leading cause of death worldwide; sepsis is one of the main contributors. The etiologies of community-acquired neonatal bacteremia in developing countries have not been well characterized.
Related JoVE Video
Neonatal mortality risks among preterm births in a rural bangladeshi cohort.
Paediatr Perinat Epidemiol
PUBLISHED: 09-16-2014
Show Abstract
Hide Abstract
Preterm birth leads to an estimated 35% of neonatal deaths worldwide. Our study analyses neonatal mortality risks among preterm births in rural Bangladesh.
Related JoVE Video
A role for science investments in advancing newborn health.
Sci Transl Med
PUBLISHED: 09-12-2014
Show Abstract
Hide Abstract
Progress in reducing the mortality of young children cannot be maintained without prioritization, funding, and implementation of neonatal interventions worldwide. Efforts to develop and deliver successful interventions must take a local perspective on problems and solutions, work through local policy processes and health care providers, and link to broader multisector efforts.
Related JoVE Video
Newborn health: everybody's business.
Glob Public Health
PUBLISHED: 06-23-2014
Show Abstract
Hide Abstract
Despite advances in issue-attention and in evidence of what works to save newborn lives (e.g., kangaroo mother care, antenatal corticosteroids, immediate and exclusive breastfeeding), we are still falling short on impact. To advance the unfinished newborn survival agenda, newborns must become an integral priority in developing countries where the burden of neonatal mortality is highest. Interventions must be adapted to local contexts and cultures and integrated into packages along the continuum of care delivered through the primary health-care systems that countries have at their disposal.
Related JoVE Video
Mechanism for prevention of infection in preterm neonates by topical emollients: a randomized, controlled clinical trial.
Pediatr. Infect. Dis. J.
PUBLISHED: 05-24-2014
Show Abstract
Hide Abstract
Topical applications of emollients such as sunflower seed oil and Aquaphor have been shown to reduce the incidence of bloodstream infections and mortality of preterm infants in resource-poor settings. The causal mechanism for prevention of infection through cutaneous portals of entry is not well understood.
Related JoVE Video
Who has been caring for the baby?
Lancet
PUBLISHED: 05-19-2014
Show Abstract
Hide Abstract
Nearly a decade ago, The Lancet published the Neonatal Survival Series, with an ambitious call for integration of newborn care across the continuum of reproductive, maternal, newborn, and child health and nutrition (RMNCH). In this first of five papers in the Every Newborn Series, we consider what has changed during this decade, assessing progress on the basis of a systematic policy heuristic including agenda-setting, policy formulation and adoption, leadership and partnership, implementation, and evaluation of effect. Substantial progress has been made in agenda setting and policy formulation for newborn health, as witnessed by the shift from maternal and child health to maternal, newborn, and child health as a standard. However, investment and large-scale implementation have been disappointingly small, especially in view of the size of the burden and potential for rapid change and synergies throughout the RMNCH continuum. Moreover, stillbirths remain invisible on the global health agenda. Hence that progress in improvement of newborn survival and reduction of stillbirths lags behind that of maternal mortality and deaths for children aged 1-59 months is not surprising. Faster progress is possible, but with several requirements: clear communication of the interventions with the greatest effect and how to overcome bottlenecks for scale-up; national leadership, and technical capacity to integrate and implement these interventions; global coordination of partners, especially within countries, in provision of technical assistance and increased funding; increased domestic investment in newborn health, and access to specific commodities and equipment where needed; better data to monitor progress, with local data used for programme improvement; and accountability for results at all levels, including demand from communities and mortality targets in the post-2015 framework. Who will step up during the next decade to ensure decision making in countries leads to implementation of stillbirth and newborn health interventions within RMNCH programmes?
Related JoVE Video
Incidence and risk factors of preterm birth in a rural Bangladeshi cohort.
BMC Pediatr
PUBLISHED: 04-15-2014
Show Abstract
Hide Abstract
Globally, about 15 million neonates are born preterm and about 85% of global preterm birth occurs in Asia and Africa regions. We aimed to estimate the incidence and risk factors for preterm birth in a rural Bangladeshi cohort.
Related JoVE Video
Developing the "120 by 20" goal for the Global FP2020 Initiative.
Stud Fam Plann
PUBLISHED: 03-12-2014
Show Abstract
Hide Abstract
This report describes the purpose for developing a quantitative goal for the London Summit on Family Planning held in July 2012, the methodology behind its formulation, and the lessons learned in the process. The London Summit has evolved into the global initiative known as FP2020, and the goal has become "120 by 20," or reaching 120 million additional users of modern contraceptive methods by 2020 in the world's poorest countries. The success of FP2020 will first be evaluated on the basis of quantitative verification to determine that the "120 by 20" goal was reached. More important, however, is the extent to which the goal today serves as a global rallying cry to mobilize resources and leadership around current family planning programs, with a focus on voluntary family planning and quality of care, and with an emphasis on meeting girls' and women's unmet needs and their right to practice contraception. We hope this article provides greater transparency and understanding of the FP2020 goal, and that the global goal spurs annual monitoring of progress toward national goals in the world's poorest countries.
Related JoVE Video
Seasonality of birth outcomes in rural Sarlahi District, Nepal: a population-based prospective cohort.
BMC Pregnancy Childbirth
PUBLISHED: 03-06-2014
Show Abstract
Hide Abstract
While seasonality of birth outcomes has been documented in a variety of settings, data from rural South Asia are lacking. We report a descriptive study of the seasonality of prematurity, low birth weight, small for gestational age, neonatal deaths, and stillbirths in the plains of Nepal.
Related JoVE Video
Validation of a rapid neurodevelopmental assessment tool for 5 to 9 year-old children in Bangladesh.
J. Pediatr.
PUBLISHED: 02-06-2014
Show Abstract
Hide Abstract
To validate a rapid neurodevelopmental assessment tool for use by child care professionals to determine neurodevelopmental impairments (NDIs) in children ages 5-9 years (61-108 months) in Bangladesh.
Related JoVE Video
Determinants and pattern of care seeking for preterm newborns in a rural Bangladeshi cohort.
BMC Health Serv Res
PUBLISHED: 01-15-2014
Show Abstract
Hide Abstract
Despite the increased burden of preterm birth and its complications, the dearth of care seeking data for preterm newborns remains a significant knowledge gap. Among preterm babies in rural Bangladesh, we examined: 1) determinants and patterns of care seeking, and 2) risk analysis for care-seeking from qualified and unqualified providers.
Related JoVE Video
Intrapartum-related neonatal encephalopathy incidence and impairment at regional and global levels for 2010 with trends from 1990.
Pediatr. Res.
PUBLISHED: 12-25-2013
Show Abstract
Hide Abstract
Background:Intrapartum hypoxic events ("birth asphyxia") may result in stillbirth, neonatal or postneonatal mortality, and impairment. Systematic morbidity estimates for the burden of impairment outcomes are currently limited. Neonatal encephalopathy (NE) following an intrapartum hypoxic event is a strong predictor of long-term impairment.Methods:Linear regression modeling was conducted on data identified through systematic reviews to estimate NE incidence and time trends for 184 countries. Meta-analyses were undertaken to estimate the risk of NE by sex of the newborn, neonatal case fatality rate, and impairment risk. A compartmental model estimated postneonatal survivors of NE, depending on access to care, and then the proportion of survivors with impairment. Separate modeling for the Global Burden of Disease 2010 (GBD2010) study estimated disability adjusted life years (DALYs), years of life with disability (YLDs), and years of life lost (YLLs) attributed to intrapartum-related events.Results:In 2010, 1.15 million babies (uncertainty range: 0.89-1.60 million; 8.5 cases per 1,000 live births) were estimated to have developed NE associated with intrapartum events, with 96% born in low- and middle-income countries, as compared with 1.60 million in 1990 (11.7 cases per 1,000 live births). An estimated 287,000 (181,000-440,000) neonates with NE died in 2010; 233,000 (163,000-342,000) survived with moderate or severe neurodevelopmental impairment; and 181,000 (82,000-319,000) had mild impairment. In GBD2010, intrapartum-related conditions comprised 50.2 million DALYs (2.4% of total) and 6.1 million YLDs.Conclusion:Intrapartum-related conditions are a large global burden, mostly due to high mortality in low-income countries. Universal coverage of obstetric care and neonatal resuscitation would prevent most of these deaths and disabilities. Rates of impairment are highest in middle-income countries where neonatal intensive care was more recently introduced, but quality may be poor. In settings without neonatal intensive care, the impairment rate is low due to high mortality, which is relevant for the scale-up of basic neonatal resuscitation.
Related JoVE Video
Incidence of and risk factors for neonatal jaundice among newborns in southern Nepal.
Trop. Med. Int. Health
PUBLISHED: 09-23-2013
Show Abstract
Hide Abstract
To quantify the incidence of and risk factors for neonatal jaundice among infants referred for care from a rural, low-resource, population-based cohort in southern Nepal.
Related JoVE Video
Animal husbandry practices in rural Bangladesh: potential risk factors for antimicrobial drug resistance and emerging diseases.
Am. J. Trop. Med. Hyg.
PUBLISHED: 09-23-2013
Show Abstract
Hide Abstract
Antimicrobial drug administration to household livestock may put humans and animals at risk for acquisition of antimicrobial drug-resistant pathogens. To describe animal husbandry practices, including animal healthcare-seeking and antimicrobial drug use in rural Bangladesh, we conducted semi-structured in-depth interviews with key informants, including female household members (n = 79), village doctors (n = 10), and pharmaceutical representatives, veterinarians, and government officials (n = 27), and performed observations at animal health clinics (n = 3). Prevalent animal husbandry practices that may put persons at risk for acquisition of pathogens included shared housing and water for animals and humans, antimicrobial drug use for humans and animals, and crowding. Household members reported seeking human and animal healthcare from unlicensed village doctors rather than formal-sector healthcare providers and cited cost and convenience as reasons. Five times more per household was spent on animal than on human healthcare. Strengthening animal and human disease surveillance systems should be continued. Interventions are recommended to provide vulnerable populations with a means of protecting their livelihood and health.
Related JoVE Video
Scientific rationale for study design of community-based simplified antibiotic therapy trials in newborns and young infants with clinically diagnosed severe infections or fast breathing in South Asia and sub-Saharan Africa.
Pediatr. Infect. Dis. J.
PUBLISHED: 08-16-2013
Show Abstract
Hide Abstract
Newborns and young infants suffer high rates of infections in South Asia and sub-Saharan Africa. Timely access to appropriate antibiotic therapy is essential for reducing mortality. In an effort to develop community case management guidelines for young infants, 0-59 days old, with clinically diagnosed severe infections, or with fast breathing, 4 trials of simplified antibiotic therapy delivered in primary care clinics (Pakistan, Democratic Republic of Congo, Kenya and Nigeria) or at home (Bangladesh and Nigeria) are being conducted.
Related JoVE Video
Ongoing trials of simplified antibiotic regimens for the treatment of serious infections in young infants in South Asia and sub-Saharan Africa: implications for policy.
Pediatr. Infect. Dis. J.
PUBLISHED: 08-16-2013
Show Abstract
Hide Abstract
The current World Health Organization (WHO) recommendation for treatment of severe infection in young infants is hospitalization and parenteral antibiotic therapy. Hospital care is generally not available outside large cities in low- and middle-income countries and even when available is not acceptable or affordable for many families. Previous research in Bangladesh and India demonstrated that treatment outside hospitals may be possible.
Related JoVE Video
Ensuring quality in AFRINEST and SATT: clinical standardization and monitoring.
Pediatr. Infect. Dis. J.
PUBLISHED: 08-16-2013
Show Abstract
Hide Abstract
Three randomized open-label clinical trials [Simplified Antibiotic Therapy Trial (SATT) Bangladesh, SATT Pakistan and African Neonatal Sepsis Trial (AFRINEST)] were developed to test the equivalence of simplified antibiotic regimens compared with the standard regimen of 7 days of parenteral antibiotics. These trials were originally conceived and designed separately; subsequently, significant efforts were made to develop and implement a common protocol and approach. Previous articles in this supplement briefly describe the specific quality control methods used in the individual trials; this article presents additional information about the systematic approaches used to minimize threats to validity and ensure quality across the trials.
Related JoVE Video
An innovative multipartner research program to address detection, assessment and treatment of neonatal infections in low-resource settings.
Pediatr. Infect. Dis. J.
PUBLISHED: 08-16-2013
Show Abstract
Hide Abstract
In pursuit of innovative approaches for the management of severe infections in young infants, which is a major cause of mortality, a multipartner research program was conceptualized to provide right care in the right place. The primary objective was to generate evidence and identify a simple, safe and effective treatment regimen for young infants with severe infections that can be provided closer to home by trained health workers where referral is not possible.
Related JoVE Video
A strategy for reducing maternal and newborn deaths by 2015 and beyond.
BMC Pregnancy Childbirth
PUBLISHED: 07-27-2013
Show Abstract
Hide Abstract
Achievement of Millennium Development Goal (MDG) 4 for child survival requires acceleration of gains in newborn survival, and current trends in improving maternal health will also fall short of reaching MDG 5 without more strategic actions. We present a Maternal Newborn and Child Health (MNCH) strategy for accelerating progress on MDGs 4 and 5, sustaining the gains beyond 2015, and further bringing down maternal and child mortality by two thirds by 2030.
Related JoVE Video
Sex differences in neonatal mortality in Sarlahi, Nepal: the role of biology and environment.
J Epidemiol Community Health
PUBLISHED: 07-19-2013
Show Abstract
Hide Abstract
Studies in South Asia have documented increased risk of neonatal mortality among girls, despite evidence of a biological survival advantage. Associations between gender preference and mortality are cited as reasons for excess mortality among girls. This has not, however, been tested in statistical models.
Related JoVE Video
Related JoVE Video
Chlorhexidine cleansing of the umbilical cord and separation time: a cluster-randomized trial.
Pediatrics
PUBLISHED: 03-18-2013
Show Abstract
Hide Abstract
Cord cleansing with chlorhexidine reduces neonatal mortality. We aimed to quantify the impact of this intervention on cord separation time and the implications of such an increase on maternal and other caretakers acceptance of chlorhexidine in future scaled up programs.
Related JoVE Video
Preterm birth and neurodevelopment: a review of outcomes and recommendations for early identification and cost-effective interventions.
J. Trop. Pediatr.
PUBLISHED: 03-13-2013
Show Abstract
Hide Abstract
This review summarizes research findings to date on neurological and health outcomes following preterm birth, tools to identify children at risk for neurodevelopmental impairment and interventions to prevent preterm birth and improve outcomes. We bring together findings from research in high- and low-income countries, with an aim to provide a global perspective on the issues. Around the world, preterm birth is rising in importance as a cause of under-five morbidity and mortality, and we project that this trend will continue over time, particularly given the lack of interventions to prevent the condition. With the development of improved screening instruments, further identification and scale up of cost-effective interventions to optimize early childhood development and accelerated research on the underlying biological mechanisms, we have an opportunity to reduce rates of neurodevelopmental impairment, particularly in countries with the highest burden.
Related JoVE Video
Injections during labor and intrapartum-related hypoxic injury and mortality in rural southern Nepal.
Int J Gynaecol Obstet
PUBLISHED: 02-11-2013
Show Abstract
Hide Abstract
To estimate the association between unmonitored use of injections during labor and intrapartum-related neonatal mortality and morbidity among home births.
Related JoVE Video
Clustering of neonatal deaths in Bangladesh: results from the Projahnmo studies.
Paediatr Perinat Epidemiol
PUBLISHED: 02-05-2013
Show Abstract
Hide Abstract
Neonatal mortality (NM) tends to be clustered within a small subset of mothers, households and/or geographical areas. Knowledge of the maternal and newborn factors associated with NM can help identify high-risk mothers and guide the targeting of intervention programmes.
Related JoVE Video
Validation of rapid neurodevelopmental assessment for 2- to 5-year-old children in Bangladesh.
Pediatrics
PUBLISHED: 01-28-2013
Show Abstract
Hide Abstract
Validate a tool to determine neurodevelopmental impairments (NDIs) in >2- to 5-year-old children in a country with limited child development expertise.
Related JoVE Video
Impact of community-based behaviour-change management on perceived neonatal morbidity: a cluster-randomized controlled trial in Shivgarh, Uttar Pradesh, India.
J. Trop. Pediatr.
PUBLISHED: 12-06-2011
Show Abstract
Hide Abstract
In the context of high neonatal mortality rate (NMR) in developing country settings, a promising strategy for enhancing newborn health is promotion of preventive newborn care practices. We measured the effect of a behaviour-change intervention on perceived neonatal illnesses in rural Uttar Pradesh, India. The study was nested in a cluster-randomized controlled trial of the impact of a package of essential newborn care on NMR. We prospectively enrolled 802 mothers and administered a questionnaire on perceived neonatal morbidities. Regression analysis showed that newborns in the intervention clusters had significantly lower risk of perceived diarrhoea [adjusted relative risk (aRR) 0.67, 95% confidence interval (CI) 0.49-0.90] and skin-related complications [aRR 0.67, 95% CI 0.45-1.00] compared to newborns in the comparison area. Assuming incidence of perceived illnesses is a proxy for actual morbidity rates, we conclude that promotion of preventive care practices through behaviour-change interventions was effective in reducing neonatal morbidities.
Related JoVE Video
Related JoVE Video
Incidence of and risk factors for neonatal respiratory depression and encephalopathy in rural Sarlahi, Nepal.
Pediatrics
PUBLISHED: 09-26-2011
Show Abstract
Hide Abstract
To characterize the incidence of, risk factors for, and neonatal morbidity and mortality associated with respiratory depression at birth and neonatal encephalopathy (NE) among term infants in a developing country.
Related JoVE Video
Home care practices for newborns in rural southern Nepal during the first 2 weeks of life.
J. Trop. Pediatr.
PUBLISHED: 06-24-2011
Show Abstract
Hide Abstract
The provision of essential newborn care through integrated packages is essential to improving survival. We analyzed data on newborn care practices collected among infants who participated in a community-based trial in rural Nepal. Analysis focused on feeding, hygienic, skin/cord care and thermal care practices. Data were analyzed for 23,356 and 22,766 newborns on Days 1 and 14, respectively. About 56.6% of the babies were breastfed within 24 h and 80.4% received pre-lacteal feeds within the first 2 weeks of life. Only 13.3% of the caretakers always washed their hands before caring for their infant. Massage with mustard oil was near universal, 82.2% of the babies slept in a warmed room and skin-to-skin contact was rare (4.5%). Many of these commonly practiced behaviors are detrimental to the health and survival of newborns. Key areas to be addressed when designing a community-endorsed care package were identified.
Related JoVE Video
Utilization and perceptions of neonatal healthcare providers in rural Uttar Pradesh, India.
Int J Qual Health Care
PUBLISHED: 06-13-2011
Show Abstract
Hide Abstract
To describe the utilization and perceptions of existing neonatal health services in rural Uttar Pradesh, India.
Related JoVE Video
Opportunities for improving, adapting and introducing emollient therapy and improved newborn skin care practices in Africa.
J. Trop. Pediatr.
PUBLISHED: 05-10-2011
Show Abstract
Hide Abstract
Infections and complications from prematurity cause a majority of global neonatal deaths. Recent evidence has demonstrated the life-saving ability of topical emollient therapy in resource-poor settings. With the potential to reduce infection and neonatal mortality by 41 and 26%, respectively, emollient therapy is a promising option for improving newborn care. While application of oil to the newborn is nearly universal in South Asia, little is known about this behavior in Africa. This article draws on literature regarding neonatal skin care in Africa to describe behaviors, motivations and potential for introducing topical emollients. Oil massage does not appear to be universal. When oil massage occurs, substances of unknown toxicity and possibly damaging massage practices are used; thus, there is scope for introduction of improved therapeutic practices. Overall, more research is needed to develop the evidence base of current neonatal skin care behaviors in Africa, and to determine emollient therapy effectiveness there.
Related JoVE Video
Vulnerability of newborns to environmental factors: findings from community based surveillance data in Bangladesh.
Int J Environ Res Public Health
PUBLISHED: 05-06-2011
Show Abstract
Hide Abstract
Infection is the major cause of neonatal deaths. Home born newborns in rural Bangladeshi communities are exposed to environmental factors increasing their vulnerability to a number of disease agents that may compromise their health. The current analysis was conducted to assess the association of very severe disease (VSD) in newborns in rural communities with temperature, rainfall, and humidity. A total of 12,836 newborns from rural Sylhet and Mirzapur communities were assessed by trained community health workers using a sign based algorithm. Records of temperature, humidity, and rainfall were collected from the nearest meteorological stations. Associations between VSD and environmental factors were estimated. Incidence of VSD was found to be associated with higher temperatures (odds ratios: 1.14, 95% CI: 1.08 to 1.21 in Sylhet and 1.06, 95% CI: 1.04 to 1.07 in Mirzapur) and heat humidity index (odds ratios: 1.06, 95% CI: 1.04 to 1.08 in Sylhet and, 1.03, 95% CI: 1.01 to 1.04 in Mirzapur). Four months (June-September) in Sylhet, and six months in Mirzapur (April-September) had higher odds ratios of incidence of VSD as compared to the remainder of the year (odds ratios: 1.72, 95% CI: 1.32 to 2.23 in Sylhet and, 1.62, 95% CI: 1.33 to 1.96 in Mirzapur). Prevention of VSD in neonates can be enhanced if these interactions are considered in health intervention strategies.
Related JoVE Video
Neonatal resuscitation and immediate newborn assessment and stimulation for the prevention of neonatal deaths: a systematic review, meta-analysis and Delphi estimation of mortality effect.
BMC Public Health
PUBLISHED: 04-13-2011
Show Abstract
Hide Abstract
Of 136 million babies born annually, around 10 million require assistance to breathe. Each year 814,000 neonatal deaths result from intrapartum-related events in term babies (previously "birth asphyxia") and 1.03 million from complications of prematurity. No systematic assessment of mortality reduction from tactile stimulation or resuscitation has been published.
Related JoVE Video
Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect.
BMC Public Health
PUBLISHED: 04-13-2011
Show Abstract
Hide Abstract
Annually over 520,000 newborns die from neonatal sepsis, and 60,000 more from tetanus. Estimates of the effect of clean birth and postnatal care practices are required for evidence-based program planning.
Related JoVE Video
Care during labor and birth for the prevention of intrapartum-related neonatal deaths: a systematic review and Delphi estimation of mortality effect.
BMC Public Health
PUBLISHED: 04-13-2011
Show Abstract
Hide Abstract
Our objective was to estimate the effect of various childbirth care packages on neonatal mortality due to intrapartum-related events ("birth asphyxia") in term babies for use in the Lives Saved Tool (LiST).
Related JoVE Video
Stillbirths: the vision for 2020.
Lancet
PUBLISHED: 04-13-2011
Show Abstract
Hide Abstract
Stillbirth is a common adverse pregnancy outcome, with nearly 3 million third-trimester stillbirths occurring worldwide each year. 98% occur in low-income and middle-income countries, and more than 1 million stillbirths occur in the intrapartum period, despite many being preventable. Nevertheless, stillbirth is practically unrecognised as a public health issue and few data are reported. In this final paper in the Stillbirths Series, we call for inclusion of stillbirth as a recognised outcome in all relevant international health reports and initiatives. We ask every country to develop and implement a plan to improve maternal and neonatal health that includes a reduction in stillbirths, and to count stillbirths in their vital statistics and other health outcome surveillance systems. We also ask for increased investment in stillbirth-related research, and especially research aimed at identifying and addressing barriers to the aversion of stillbirths within the maternal and neonatal health systems of low-income and middle-income countries. Finally, we ask all those interested in reducing stillbirths to join with advocates for the improvement of other pregnancy-related outcomes, for mothers and their offspring, so that a united front for improved pregnancy and neonatal care for all will become a reality.
Related JoVE Video
Levels, timing, and etiology of stillbirths in Sylhet district of Bangladesh.
BMC Pregnancy Childbirth
PUBLISHED: 04-01-2011
Show Abstract
Hide Abstract
Lack of data is a critical barrier to addressing the problem of stillbirth in countries with the highest stillbirth burden. Our study objective was to estimate the levels, types, and causes of stillbirth in rural Sylhet district of Bangladesh.
Related JoVE Video
Effect of knowledge of community health workers on essential newborn health care: a study from rural India.
Health Policy Plan
PUBLISHED: 03-08-2011
Show Abstract
Hide Abstract
This study explored the relationship between the knowledge of community health workers (CHWs)-anganwadi workers (AWWs) and auxiliary nurse midwives (ANMs)-and their antenatal home visit coverage and effectiveness of the visits, in terms of essential newborn health care practices at the household level in rural India.
Related JoVE Video
Community-based stillbirth rates and risk factors in rural Sarlahi, Nepal.
Int J Gynaecol Obstet
PUBLISHED: 02-24-2011
Show Abstract
Hide Abstract
To assess stillbirth rates and antepartum risk factors in rural Nepal.
Related JoVE Video
Randomized study of vaginal and neonatal cleansing with 1% chlorhexidine.
Int J Gynaecol Obstet
PUBLISHED: 01-17-2011
Show Abstract
Hide Abstract
To determine the safety, acceptability, and antimicrobial effect of 1% chlorhexidine (CHX) vaginal washing of women in labor and their neonates.
Related JoVE Video
Why is continuum of care from home to health facilities essential to improve perinatal survival?
Semin. Perinatol.
PUBLISHED: 11-25-2010
Show Abstract
Hide Abstract
The period around the time of delivery is extremely hazardous for infants in developing countries. After the first week the risk drops sharply, and survival improves markedly. To reduce perinatal mortality, a continuum of care between the home and the various facilities is essential during pregnancy, childbirth and the newborn period. This paper reviews strategies to promote the establishment of this continuum: providing health care within or close to home by frontline workers and increasing the use of services in health facilities through community mobilization and financing strategies. As perinatal care and care for seriously sick children face common challenges and lessons could be learned from successful strategies for management of other illnesses, this paper also reviews intervention models involving community health workers (CHWs) to improve case management of sick children at the household and community levels. Available evidence suggests that the community strategy with the greatest impact on neonatal mortality is home visits by CHWs combined with community mobilization. The same strategy appears to be effective in increasing health facility utilization. An equally effective strategy for increasing health facility utilization seems to be financing health care to remove financial access barriers, particularly using conditional cash transfers or vouchers. Although the availability of information on the effect of community interventions to improve newborn health has increased in the recent past, significant gaps remain. Information on the effectiveness of strategies in different settings, particularly in sub-Saharan Africa, cost-effectiveness and sustainability are particularly needed and should be gathered in future studies.
Related JoVE Video
Community-based intervention packages for improving perinatal health in developing countries: a review of the evidence.
Semin. Perinatol.
PUBLISHED: 11-25-2010
Show Abstract
Hide Abstract
The Lancet Neonatal Survival Series categorized neonatal health interventions into 3 service delivery modes: "Outreach," "Family-Community Care," and "Facility-based Clinical Care." Family-Community Care services generally have a greater potential impact on neonatal health than Outreach services, with similar costs. Combining interventions from all 3 service delivery modes is ideal for achievement of high impact. However, access to clinical care is limited in resource-poor settings with weak health systems. The current trend for those settings is to combine neonatal interventions into community-based intervention packages (CBIPs), which can be integrated into the local health care system. In this article, we searched several large databases to identify all published, large-scale, controlled studies that were implemented in a rural setting, included a control group, and reported neonatal and/or perinatal mortality as outcomes. We identified only 9 large-scale studies that fit these criteria. Several conclusions can be reached. (1) Family-Community Care interventions can have a substantial effect on neonatal and perinatal mortality. (2) Several important common strategies were used across the studies, including community mobilization, health education, behavior change communication sessions, care seeking modalities, and home visits during pregnancy and after birth. However, implementation of these interventions varied widely across the studies. (3) There is a need for additional, large-scale studies to test evidence-based CBIPs in developing countries, particularly in Africa, where no large-scale studies were identified. (4) We need to establish consistent, clearly defined terminology and protocols for designing trials and reporting outcomes so that we are able to compare results across different settings. (5) There is an urgent need to invest in research and program development focusing on neonatal health in urban areas. (6) It is crucial to integrate CBIPs in rural and urban settings into the already existing health care system to facilitate sustainability of the program and for scaling up. It is also important to evaluate the packages and to demonstrate the health impact of large-scale implementation. (7) Finally, there is a need for improving the continuum of care between home and facility-based care.
Related JoVE Video
Behavior change for newborn survival in resource-poor community settings: bridging the gap between evidence and impact.
Semin. Perinatol.
PUBLISHED: 11-25-2010
Show Abstract
Hide Abstract
Despite an established evidence base of simple, affordable, and low-cost interventions to avert neonatal deaths, global progress in reducing neonatal mortality has stagnated in recent years. Under-recognition of the critical role played by behavior change in ensuring adoption and dissemination of innovations is a major reason for this gap between evidence and impact. A general lack of understanding of the mechanisms underlying behavior change at a population level coupled with an under-appreciation of the sociocultural context of newborn care behaviors has underscored ill-informed approaches towards behavior change that have met with limited success. This article draws upon available evidence from prevention-oriented, community-based newborn survival trials to derive insights into the role of behavior change in neonatal mortality reduction. We propose a simple model, the intervention-causation pathway, to explain the pathway through which behavior change interventions may lead to reductions in mortality. Further, we explore the unique nature of newborn care behaviors and their underlying sociocultural context, along with state-of-the-art advances in social, behavioral, and management sciences. These principles form the basis of the behavior change management framework that has successfully guided intervention design and implementation, leading to high impact on neonatal mortality reduction, in Uttar Pradesh, India. We describe how the behavior change management framework can be applied to inform the design of theoretically and empirically sound behavior change interventions with greater precision, predictability and pace towards reduction in neonatal mortality. We finally touch upon key overarching principles that should guide intervention execution for maximal impact.
Related JoVE Video
Preventing preterm birth and neonatal mortality: exploring the epidemiology, causes, and interventions.
Semin. Perinatol.
PUBLISHED: 11-25-2010
Show Abstract
Hide Abstract
Globally, each year, an estimated 13 million infants are born before 37 completed weeks of gestation. Complications from these preterm births are the leading cause of neonatal mortality. Preterm birth is directly responsible for an estimated one million neonatal deaths annually and is also an important contributor to child and adult morbidities. Low- and middle-income countries are disproportionately affected by preterm birth and carry a greater burden of disease attributed to preterm birth. Causes of preterm birth are multifactorial, vary by gestational age, and likely vary by geographic and ethnic contexts. Although many interventions have been evaluated, few have moderate-to high-quality evidence for decreasing preterm birth: smoking cessation and progesterone treatment in women with a high risk of preterm birth in low- and middle-income countries and cervical cerclage for those in high-income countries. Antepartum and postnatal interventions (eg, antepartum maternal steroid administration, or kangaroo mother care) to improve preterm neonatal survival after birth have been demonstrated to be effective but have not been widely implemented. Further research efforts are urgently needed to better understand context-specific pathways leading to preterm birth; to develop appropriate, efficacious prevention strategies and interventions to improve survival of neonates born prematurely; and to scale-up known efficacious interventions to improve the health of the preterm neonate.
Related JoVE Video
Reducing intrapartum-related neonatal deaths in low- and middle-income countries-what works?
Semin. Perinatol.
PUBLISHED: 11-25-2010
Show Abstract
Hide Abstract
Each year, 814,000 neonatal deaths and 1.02 million stillbirths result from intrapartum-related causes, such as intrauterine hypoxia. Almost all of these deaths are in low- and middle-income countries, where women frequently lack access to quality perinatal care and may delay care-seeking. Approximately 60 million annual births occur outside of health facilities, and most of these childbirths are without a skilled birth attendant. Conditions that increase the risk of intrauterine hypoxia--such as pre-eclampsia/eclampsia, obstructed labor, and low birth weight--are often more prevalent in low resource settings. Intrapartum-related neonatal deaths can be averted by a range of interventions that prevent intrapartum complications (eg, prevention and management of pre-eclampsia), detect and manage intrapartum problems (eg, monitoring progress of labor with access to emergency obstetrical care), and identify and assist the nonbreathing newborn (eg, stimulation and bag-mask ventilation). Simple, affordable, and effective approaches are available for low-resource settings, including community-based strategies to increase skilled birth attendance, partograph use by frontline health workers linked to emergency obstetrical care services, task shifting to increase access to Cesarean delivery, and simplified neonatal resuscitation training (Helping Babies Breathe(SM)). Coverage of effective interventions is low, however, and many opportunities are missed to provide quality care within existing health systems. In sub-Saharan Africa, recent health services assessments found only 15% of hospitals equipped to provide basic neonatal resuscitation. In the short term, intrapartum-related neonatal deaths can be substantially reduced by improving the quality of services for all childbirths that occur in health facilities, identifying and addressing the missed opportunities to provide effective interventions to those who seek facility-based care. For example, providing neonatal resuscitation for 90% of deliveries currently taking place in health facilities would save more than 93,000 newborn lives each year. Longer-term strategies must address the gaps in coverage of institutional delivery, skilled birth attendance, and quality by strengthening health systems, increasing demand for care, and improving community-based services. Both short- and long-term strategies to reduce intrapartum-related mortality should focus on reducing inequities in coverage and quality of obstetrical and perinatal care.
Related JoVE Video
Stillbirths: epidemiology, evidence, and priorities for action.
Semin. Perinatol.
PUBLISHED: 11-25-2010
Show Abstract
Hide Abstract
The annual global burden of stillbirths amounts to an estimated 3.2 million%, 98% of which occur in low- and middle-income countries (LMICs). Of these, 1.02 million (32%) are intrapartum, ie, taking place during labor. The most important causes of stillbirths in LMICs include obstructed or prolonged labor, hypertensive diseases of pregnancy, syphilis and gram-negative infections, malaria in endemic areas, and undernutrition. Interventions that target these causes can play an important role in reducing stillbirths. There is a clear benefit of emergency obstetrical care, particularly Cesarean delivery, on intrapartum rates in LMICs when Cesarean rates are less than 8% to 10%. Provision of a skilled birth attendant is another important intervention whereby labor complications can be prevented, identified, managed, and/or referred. Among interventions for infections, syphilis screening and treatment can prevent as many as 50% of all stillbirths in areas with high syphilis prevalence, reducing the risk of stillbirths among treated women to that of untreated women. Intermittent preventive treatment of malaria and insecticide-treated mosquito nets are also interventions with strong recommendation, especially in the first 2 pregnancies. Balanced energy protein supplementation is an important nutritional intervention to prevent stillbirths in undernourished women, especially in LMICs. Creation of increased demand for health services within communities and increasing their uptake also can play a role in averting stillbirths. Other potential social and behavioral interventions include birth spacing, smoking cessation and indoor air pollution control, although the evidence for these is weak.
Related JoVE Video
Improving the sensitivity of blood culture for Streptococcus pneumoniae.
J. Trop. Pediatr.
PUBLISHED: 08-24-2010
Show Abstract
Hide Abstract
Isolation of Streptococcus pneumoniae is jeopardized by low sensitivity of blood culture, autolysis and contamination with fast-growing organism(s). We performed an immunochromatographic (ICT) test for S. pneumoniae on chocolatized blood culture bottles and also sub-cultured contaminated bottles on a selective medium, thus identifying an additional eight and three cases, respectively, and improving the detection of pneumococcus by 23% (48% vs. 59%). Prescreening of culture bottles in a blinded fashion could rationalize the use of ICT with ~99% accuracy. These two approaches can aid microbiology laboratories in resource-poor countries to substantially improve rates of detection of S. pneumoniae.
Related JoVE Video
Risk of mortality associated with neonatal hypothermia in southern Nepal.
Arch Pediatr Adolesc Med
PUBLISHED: 07-07-2010
Show Abstract
Hide Abstract
To quantify the neonatal mortality/hypothermia relationship and develop evidence-based cutoffs for global definitions of neonatal hypothermia.
Related JoVE Video
Neonatal hypothermia and associated risk factors among newborns of southern Nepal.
BMC Med
PUBLISHED: 06-22-2010
Show Abstract
Hide Abstract
Neonatal hypothermia is associated with an increased mortality risk for 28 days. There are few community-based data on specific risk factors for neonatal hypothermia. Estimates of association between neonatal hypothermia in the community and risk factors are needed to guide the design of interventions to reduce exposure.
Related JoVE Video
Incidence of neonatal hyperbilirubinemia: a population-based prospective study in Pakistan.
Trop. Med. Int. Health
PUBLISHED: 04-24-2010
Show Abstract
Hide Abstract
To estimate the incidence of neonatal jaundice and hyperbilirubinemia in a poor urban community in Karachi, where 70% of births occur at home.
Related JoVE Video
Comparing modelled predictions of neonatal mortality impacts using LiST with observed results of community-based intervention trials in South Asia.
Int J Epidemiol
PUBLISHED: 03-30-2010
Show Abstract
Hide Abstract
There is an increasing body of evidence from trials suggesting that major reductions in neonatal mortality are possible through community-based interventions. Since these trials involve packages of varying content, determining how much of the observed mortality reduction is due to specific interventions is problematic. The Lives Saved Tool (LiST) is designed to facilitate programmatic prioritization by modelling mortality reductions related to increasing coverage of specific interventions which may be combined into packages.
Related JoVE Video
Validation of rapid neurodevelopmental assessment instrument for under-two-year-old children in Bangladesh.
Pediatrics
PUBLISHED: 03-22-2010
Show Abstract
Hide Abstract
The objective of this study was to determine the reliability and validity of a comprehensive assessment procedure for ascertaining neurodevelopmental status of children aged 0 to 24 months for use by multidisciplinary professionals in a developing country.
Related JoVE Video
"These are not good things for other people to know": how rural Tanzanian womens experiences of pregnancy loss and early neonatal death may impact survey data quality.
Soc Sci Med
PUBLISHED: 03-21-2010
Show Abstract
Hide Abstract
Little research in low-income countries has compared the social and cultural ramifications of loss in childbearing, yet the social experience of pregnancy loss and early neonatal death may affect demographers ability to measure their incidence. Ninety-five qualitative reproductive narratives were collected from 50 women in rural southern Tanzania who had recently suffered infertility, miscarriage, stillbirth or early neonatal death. An additional 31 interviews with new mothers and female elders were used to assess childbearing norms and social consequences of loss in childbearing. We found that like pregnancy, stillbirth and early neonatal death are hidden because they heighten womens vulnerability to social and physical harm, and womens discourse and behaviors are under strong social control. To protect themselves from sorcery, spiritual interference, and gossip--as well as stigma should a spontaneous loss be viewed as an induced abortion--women conceal pregnancies and are advised not to mourn or grieve for "immature" (late-term) losses. Twelve of 30 respondents with pregnancy losses had been accused of inducing an abortion; 3 of these had been subsequently divorced. Incommensurability between Western biomedical and local categories of reproductive loss also complicates measurement of losses. Similar gender inequalities and understandings of pregnancy and reproductive loss in other low-resource settings likely result in underreporting of these losses elsewhere. Cultural, terminological, and methodological factors that contribute to inaccurate measurement of stillbirth and early neonatal death must be considered in designing surveys and other research methods to measure pregnancy, stillbirth, and other sensitive reproductive events.
Related JoVE Video
Clinical signs predicting severe illness in young infants (<60 days) in Bolivia.
J. Trop. Pediatr.
PUBLISHED: 02-08-2010
Show Abstract
Hide Abstract
Identification of simple signs and symptoms that predict severe illness needing referral for admission of young infants is critical for reducing mortality in developing countries. Infants <2 months of age presenting to two hospitals in La Paz, Bolivia (n=1082) were evaluated by nurses for signs and symptoms, and independently by physicians for the need for admission. In young neonates, sensitivity of individual clinical signs was >35% for measured temperature ? 37.5° C (65%); all signs had specificity >85%. Odds ratios (ORs) for association of individual clinical signs with need for urgent hospital management were highest (>5) for history of difficulty feeding, not feeding well and fever. Clinical signs or symptoms are useful for primary healthcare workers to identify young infants with serious illness needing admission, and have been incorporated into the Integrated Management of Childhood Illness algorithm for use in Bolivia and elsewhere in Latin America.
Related JoVE Video
Cost-effectiveness of skin-barrier-enhancing emollients among preterm infants in Bangladesh.
Bull. World Health Organ.
PUBLISHED: 01-08-2010
Show Abstract
Hide Abstract
To evaluate the cost-effectiveness of topical emollients, sunflower seed oil (SSO) and synthetic Aquaphor, versus no treatment, in preventing mortality among hospitalized preterm infants (< 33 weeks gestation) at a tertiary hospital in Bangladesh.
Related JoVE Video
Incidence and seasonality of hypothermia among newborns in southern Nepal.
Arch Pediatr Adolesc Med
PUBLISHED: 01-06-2010
Show Abstract
Hide Abstract
To quantify incidence, age distribution, and seasonality of neonatal hypothermia among a large population cohort.
Related JoVE Video
Simplified dosing of gentamicin for treatment of sepsis in Bangladeshi neonates.
J Health Popul Nutr
PUBLISHED: 11-12-2009
Show Abstract
Hide Abstract
Extended-interval dosing of gentamicin has several advantages over conventional multiple-daily dosing for the treatment of sepsis. The study was conducted to evaluate the pharmacokinetics of gentamicin for the treatment of neonatal sepsis in predetermined doses at 24- or 48-hour intervals, according to weight category, and to develop a simplified protocol for use in peripheral healthcare settings in developing countries. This prospective observational study was conducted among 59 neonates admitted to the Special Care Nursery at Dhaka Shishu Hospital, Bangladesh, with suspected sepsis and treated with antibiotics, including gentamicin. Intravenous dosing of gentamicin according to weight category was: 10 mg every 48 hours if the infant weighed < 2,000 g (n = 23), 10 mg every 24 hours if the infant weighed 2,000-2,249 g (n = 12), or 13.5 mg every 24 hours if the infant weighed 2,500-3,000 g (n = 24). Peak and trough concentrations of gentamicin and the presence of signs of nephrotoxicity and ototoxicity were determined. The mean +/- standard deviation peak concentration of gentamicin was 12.3 +/- 3.7 microg/mL in infants weighing < 2,000 g, 9.6 +/- 3.1 microg/mL in infants 2,000-2,249 g, and 10.0 +/- 3.4 microg/mL in infants 2,500-3,000 g. Initial peak concentration of gentamicin was > 12 microg/mL in 28.8% and initial trough concentration was > 2 microg/mL in 6.8% of the subjects. No signs of nephrotoxicity or ototoxicity were detected. Favourable pharmacokinetic parameters found with the simplified dosing regimen suggest that it is safe for the treatment of neonatal sepsis.
Related JoVE Video
Impact of clean delivery-kit use on newborn umbilical cord and maternal puerperal infections in Egypt.
J Health Popul Nutr
PUBLISHED: 11-06-2009
Show Abstract
Hide Abstract
This cross-sectional cohort study explored the impact of the use of clean delivery-kit (CDK) on morbidity due to newborn umbilical cord and maternal puerperal infections. Kits were distributed from primary-care facilities, and birth attendants received training on kit-use. A nurse visited 334 women during the first week postpartum to administer a structured questionnaire and conduct a physical examination of the neonate and the mother. Results of bivariate analysis showed that neonates of mothers who used a CDK were less likely to develop cord infection (p = 0.025), and mothers who used a CDK were less likely to develop puerperal sepsis (p = 0.024). Results of multiple logistic regression analysis showed an independent association between decreased cord infection and kit-use [odds ratio (OR) = 0.42, 95% confidence interval (CI) 0.18-0.97, p = 0.041)]. Mothers who used a CDK also had considerably lower rates of puerperal infection (OR = 0.11, 95% CI 0.01-1.06), although the statistical strength of the association was of borderline significance (p = 0.057). The use of CDK was associated with reductions in umbilical cord and puerperal infections.
Related JoVE Video
Risk of mortality subsequent to umbilical cord infection among newborns of southern Nepal: cord infection and mortality.
Pediatr. Infect. Dis. J.
PUBLISHED: 11-05-2009
Show Abstract
Hide Abstract
Neonatal sepsis may stem from local umbilical cord infections. Signs of cord infection are common in low-resource settings, yet the risk of mortality subsequent to these signs has not been quantified in either developed or developing countries. We compared the risk of mortality between infants with and without signs of umbilical cord infection during a community-based trial of chlorhexidine interventions in southern Nepal.
Related JoVE Video
Reducing intrapartum-related deaths and disability: can the health system deliver?
Int J Gynaecol Obstet
PUBLISHED: 10-10-2009
Show Abstract
Hide Abstract
Each year 1.02 million intrapartum stillbirths and 904,000 intrapartum-related neonatal deaths (formerly called "birth asphyxia") occur, closely linked to 536,000 maternal deaths, an estimated 42% of which are intrapartum-related.
Related JoVE Video
Obstetric care in low-resource settings: what, who, and how to overcome challenges to scale up?
Int J Gynaecol Obstet
PUBLISHED: 10-10-2009
Show Abstract
Hide Abstract
Each year, approximately 2 million babies die because of complications of childbirth, primarily in settings where effective care at birth, particularly prompt cesarean delivery, is unavailable.
Related JoVE Video
Two million intrapartum-related stillbirths and neonatal deaths: where, why, and what can be done?
Int J Gynaecol Obstet
PUBLISHED: 10-10-2009
Show Abstract
Hide Abstract
Intrapartum-related neonatal deaths ("birth asphyxia") are a leading cause of child mortality globally, outnumbering deaths from malaria. Reduction is crucial to meeting the fourth Millennium Development Goal (MDG), and is intimately linked to intrapartum stillbirths as well as maternal health and MDG 5, yet there is a lack of consensus on what works, especially in weak health systems.
Related JoVE Video
Linking families and facilities for care at birth: what works to avert intrapartum-related deaths?
Int J Gynaecol Obstet
PUBLISHED: 10-10-2009
Show Abstract
Hide Abstract
Delays in receiving effective care during labor and at birth may be fatal for the mother and fetus, contributing to 2 million annual intrapartum stillbirths and intrapartum-related neonatal deaths each year.
Related JoVE Video
60 Million non-facility births: who can deliver in community settings to reduce intrapartum-related deaths?
Int J Gynaecol Obstet
PUBLISHED: 10-10-2009
Show Abstract
Hide Abstract
For the worlds 60 million non-facility births, addressing who is currently attending these births and what effect they have on birth outcomes is a key starting point toward improving care during childbirth.
Related JoVE Video
Community-based validation of assessment of newborn illnesses by trained community health workers in Sylhet district of Bangladesh.
Trop. Med. Int. Health
PUBLISHED: 10-05-2009
Show Abstract
Hide Abstract
To validate trained community health workers recognition of signs and symptoms of newborn illnesses and classification of illnesses using a clinical algorithm during routine home visits in rural Bangladesh.
Related JoVE Video

What is Visualize?

JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

How does it work?

We use abstracts found on PubMed and match them to JoVE videos to create a list of 10 to 30 related methods videos.

Video X seems to be unrelated to Abstract Y...

In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.