Lower mortality is observed among low birth weight young infants who have received home-based care by female community health volunteers in rural Nepal.

BACKGROUND: There 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. METHODS: A 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. RESULTS: Out 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). CONCLUSION: The 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.

Feasibility and acceptability of gentamicin in the Uniject prefilled injection system for community-based treatment of possible neonatal sepsis: the experience of female community health volunteers in Nepal.

OBJECTIVE: Explore feasibility and acceptability of gentamicin in the Uniject prefilled injection system, in combination with oral cotrimoxazole-p and an appropriate newborn weighing scale, for treatment of possible neonatal sepsis when administered in the community by female community health volunteers. STUDY DESIGN: In a community-based program in Nepal, 45 volunteers recorded 422 live births. Among these, 82 infants were identified as having possible severe bacterial infection. In all, 67 of these infants were treated with gentamicin in Uniject and 15 were referred to the health facility. Mixed methods were used to collect data about Uniject performance, acceptability and safety. RESULT: Volunteers successfully treated 67 infants with gentamicin in Uniject. Gentamicin in Uniject performed well and was acceptable. CONCLUSION: Gentamicin in Uniject, in combination with cotrimoxazole-p and an appropriate newborn weighing scale, is a feasible and acceptable option for treatment of possible neonatal sepsis in the community by female community health volunteers.