Pilot study: a cluster randomised trial of the provision of alcohol handgel to postpartum mothers to prevent neonatal infective morbidity in the home The research question is "Is the provision of alcohol hand gel to pregnant women in rural Uganda a clinically and cost-effective way of preventing early infant infections?". To provide context to this question across the globe, there are an estimated 3 million neonatal deaths annually. In Uganda, with over 1.5 million live births annually, 142,000 newborn infants die every year before reaching their fifth year with 33% of these in the neonatal period. This places Uganda 153rd out of 163 countries in the global rank for frequency of neonatal deaths. Most newborn infections and deaths occur in the community, and are frequently unreported to the health sector.  For example, preliminary findings from the Iganga/Mayuge Demographic Surveillance Site showed that 60% of all deaths occur outside a health facility setting and go unreported. African community studies suggest an infection rate of around 30%.  In terms of infection prevention hand washing with soap  even when washed with unclean water results in a large reduction in hand contamination. A recent systematic review concluded that there was a lack quality evidence for the effect of clean birth and postnatal newborn care practices on neonatal mortality. However, the need for clean birth and postnatal care is widely accepted. A Delphi expert consensus process judged that clean birth practices at home with no skilled attendant could reduce neonatal sepsis deaths by 15% and tetanus deaths by 30%. The panel judged that postnatal newborn care practices could prevent 40% of neonatal sepsis deaths, but that more research is needed particularly on the content and quality of care during the early postnatal period.  A research priority-setting exercise by World Health Organisation (WHO) on the reduction of newborn infection deaths found that the top ranked question was 'what is the feasibility, effectiveness, and cost of different approaches to promote the home care practices especially hand washing of caregivers?' Despite this being 4 years ago, there are no registered studies addressing the use of alcohol hand gels for mothers in the neonatal period, and local experts know of no similar study. The importance of hand-washing in preventing infective deaths has led WHO to develop guidelines for hand hygiene both within health care settings and in the community and integrate hand hygiene into neonatal community care programmes. For hand hygiene, the current recommended practice at the household level is handwashing with soap. However, studies show widespread non-adherence to the household guidelines, often due to a lack of water. An alternative option could therefore be alcohol based hand gel. This is cheap ($0.6 for 60mls) and active against a broad range of Gram-positive and Gram-negative aerobic bacteria, including staphylococci, streptococci, and enteric Gram-negative bacteria. Although alcohol-based hand rubs effectively prevent acute diarrhoeal diseases. The Global Challenges Research Fund (GCRF) supports cutting-edge research to address challenges faced by developing countries. The fund addresses the UN sustainable development goals. It aims to maximise the impact of research and innovation to improve lives and opportunity in the developing world.