Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Improving Newborn Survival in Rural Southern Tanzania: a Study to Evaluate the Impact and Cost of a Scaleable Package of Interventions at Community Level With Health System Strengthening
Brief Summary: This study will develop, implement and evaluate the effectiveness and cost of interventions at community level (focussed on a community-based health worker) and of health system strengthening on newborn survival in rural southern Tanzania.

Objectives

1. To develop and document a community-based package for improved newborn care, focussed around interpersonal communication through home visits in pregnancy and the early neonatal period .
2. To develop and document a quality improvement package for antenatal, intrapartum and postnatal care in health facilities.
3. To implement these strategies for improved newborn survival in such a way as to be both sustainable and scaleable at national level.
4. To monitor understanding of, and attitudes related to, neonatal care and survival from both health provider and community perspectives in areas with and without the interventions.
5. To measure incremental costs and cost savings to the health sector and society associated with the interventions, and to predict the cost of integrating the programme into routine health service provision and of scaling-up
6. To strengthen Tanzania's capacity to develop, implement and evaluate interventions to improve neonatal survival.
7. To estimate the effect of the interventions on newborn survival and household behaviours related to newborn health.

Study design \& methods. The interventions will be implemented in parts of Lindi and Mtwara regions. The health system quality improvement package will be implemented throughout the area and evaluated using a before-after comparison. The community intervention will be implemented initially in a randomly-chosen half of all wards (a ward is an administrative sub-area of a district). Implementation will be led by existing front-line health staff. Evaluation will include a health facility survey and a household survey to assess contacts with the agents of change, key behaviours and newborn survival in the community.


Options:
A: Arm Label: Home-based counselling visits by volunteers; Type: EXPERIMENTAL; Interventions: Behavioral: Home-based counselling | Arm Label: Standard care through existing health system; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Home-based counselling; Assigned to Arm(s): Home-based counselling visits by volunteers
B: Arm Label: Standard well child care; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Food Activity Breast feeding support; Type: EXPERIMENTAL; Interventions: Behavioral: FAB | Arm Label: Sleep; Type: EXPERIMENTAL; Interventions: Behavioral: Sleep | Arm Label: FAB + Sleep; Type: EXPERIMENTAL; Interventions: Behavioral: FAB, Behavioral: Sleep | Intervention Type: BEHAVIORAL; Name: FAB; Assigned to Arm(s): FAB + Sleep, Food Activity Breast feeding support | Intervention Type: BEHAVIORAL; Name: Sleep; Assigned to Arm(s): FAB + Sleep, Sleep
C: Arm Label: A; Type: EXPERIMENTAL; Interventions: Other: Telephone Support Intervention to Improve Breastfeeding | Arm Label: B; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: OTHER; Name: Telephone Support Intervention to Improve Breastfeeding; Assigned to Arm(s): A
D: Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Low Intensity; Type: OTHER; Interventions: Other: Telephone-based breastfeeding peer counseling | Arm Label: High Intensity; Type: ACTIVE_COMPARATOR; Interventions: Other: Telephone-based breastfeeding peer counseling | Intervention Type: OTHER; Name: Telephone-based breastfeeding peer counseling; Assigned to Arm(s): High Intensity, Low Intensity

Answer: A