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: Control; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Community Health Workers; Type: EXPERIMENTAL; Interventions: Behavioral: community health workers | Intervention Type: BEHAVIORAL; Name: community health workers; Assigned to Arm(s): Community Health Workers
B: 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
C: Arm Label: procaine penicillin and gentamicin; Type: ACTIVE_COMPARATOR; Interventions: Drug: procaine penicillin and gentamicin, Drug: procaine penicillin, gentamicin, amoxicillin | Arm Label: Amoxicillin and gentamicin; Type: EXPERIMENTAL; Interventions: Drug: amoxicillin and gentamicin, Drug: procaine penicillin, gentamicin, amoxicillin | Arm Label: procaine penicillin, gentamicin, and amoxicillin; Type: EXPERIMENTAL; Interventions: Drug: procaine penicillin, gentamicin, amoxicillin | Intervention Type: DRUG; Name: procaine penicillin and gentamicin; Assigned to Arm(s): procaine penicillin and gentamicin | Intervention Type: DRUG; Name: amoxicillin and gentamicin; Assigned to Arm(s): Amoxicillin and gentamicin | Intervention Type: DRUG; Name: procaine penicillin, gentamicin, amoxicillin; Assigned to Arm(s): Amoxicillin and gentamicin, procaine penicillin and gentamicin, procaine penicillin, gentamicin, and amoxicillin
D: Arm Label: Intervention; Type: EXPERIMENTAL; Interventions: Behavioral: Health Education & Promotion, Other: Training of Health Workers, Behavioral: Community Mobilization | Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Intervention Type: BEHAVIORAL; Name: Health Education & Promotion; Assigned to Arm(s): Intervention | Intervention Type: OTHER; Name: Training of Health Workers; Assigned to Arm(s): Intervention | Intervention Type: BEHAVIORAL; Name: Community Mobilization; Assigned to Arm(s): Intervention

Answer: B