Please select the eligibility criteria that correspond 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: Inclusion Criteria:

* pregnant women with gestation of 28 weeks or less, making their first antenatal consultation

Exclusion Criteria:

* no exclusion criteria has been developed. All women that qualify are eligible for recruitment
B: Inclusion Criteria:

* Pregnant women living in the study area

Exclusion Criteria:

* Unwilling to participate
C: Inclusion Criteria:

* Inclusion Criteria

  * Infants 0-59 days old who are residents of catchment population of the study hospitals or clinics
  * One or more of the following five signs: severe chest in-drawing, axillary temperature \>38.0C or \<35.50 C, movement only when stimulated, and history of feeding problems (confirmed by poor suck on feeding assessment)
  * Family refuses recommended hospitalization or hospitalization otherwise not feasible
  * Informed consent by a legal guardian.
* Exclusion Criteria:

Very severe infection/disease characterized by presence of any of the following signs (unconscious, convulsions, unable to feed, apnea, unable to cry, cyanosis, bulging fontanel, prolonged capillary refill, major congenital malformations, major bleeding, surgical conditions needing hospital referral, persistent vomiting defined as vomiting following three attempts to feed the baby within ½ hour)

* Very low birth weight: weight \<1500
* Hospitalization for illness in the last two weeks
* Previous inclusion in the study
D: Inclusion Criteria:

* Pregnant women \& participants who agree to participate in the study

Exclusion Criteria:

* Pregnant women \& participants who disagree to participate in the study

Answer: B