Effect of Referral Card on Neonatal Medical Care Seeking for Institutional Births in Urban Lucknow

Study Overview
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Brief Summary
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Neonatal mortality rate in Uttar Pradesh, Northern India is 53.6 per thousand, and accounts for 8% of global neonatal deaths.It has been argued that prompt and appropriate care-seeking for sick neonates can substantially reduce neonatal mortality. This pre and post intervention trial was done to assess the impact of a pictorial Neonatal referral Card and one-to-one counseling of mothers on the qualified medical care-seeking behavior for sick neonates in urban Lucknow. The study hypothesis was that the counseling on danger signs along with neonatal referral card has no impact on availing services of a qualified medical practitioner by caregivers of sick neonates.

Detailed Description
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The study was conducted in two government maternity hospitals in Lucknow. Neonates enrolled in the pre intervention phase were followed up for 6 weeks+15 days but did not recieve the study intervention. While, the mothers of the neonates enrolled in the post intervention phase recieved the study intervention within 48 hours of institutional delivery.Enrollment and follow-up procedures were same in both the phases.

Official Title
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Effect of Referral Card on Neonatal Medical Care Seeking for Institutional Births in Urban Lucknow

Conditions
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Neonatal Morbidity, Neonatal Illnesses

Intervention / Treatment
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* Behavioral: Referral Card with one-to-one counseling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Neonates born in the participating hospital within last 48 hours and the parents on which gave written informed consent to participate in the study. Exclusion Criteria: Neonates presenting with any clinically detectable congenital malformation at birth or who required any resuscitation at birth or who were admitted for any morbidity immediately after birth or those who were not the residents of Lucknow or were likely to leave the city limits within next one month.

Ages Eligible for Study
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Maximum Age: 4 Weeks

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Non-Randomized
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: 1<br>Usual Care | |
| Experimental: 2<br>Referral Card with one-to-one counseling | Behavioral: Referral Card with one-to-one counseling<br>* A Referral Card (Neonatal Well-Being Card) along with one-to-one counseling to mothers within 48 hours of institutional delivery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The utilization of health services of qualified medical care provider (attendance; hospitalization) for neonatal sickness |  | In neonatal period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To assess the causes of failure of health seeking behavior for neonatal illnesses of the community |  | in neonatal period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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neonatal illness, qualified care seeking, Behaviour change, Urban slums, India, Neonatal morbidity, Care seeking for neonatal illnesses, Qualified medical care seeking, Integrated management of neonatal and childhood illnesses (IMNCI)