Newborn community health advancements among Ethiopian Orthodox Christian women in North Gondar, Ethiopia: community-based randomised trial protocol.

Judd Walson, Daniel Gashaneh Belay, Getahun A Alemie, Katherine C Rankin, Lorie M Wild, Getayeneh Antehunegn Tesema, Dieudonne Hakizimana, Brandon L Guthrie

Journal: BMJ open 2024;14(9):e081330

PMID: 39277203

Abstract

INTRODUCTION

Despite significant progress over past decades, neonatal and infant morbidity and mortality remain unacceptably high in Ethiopia. Simple interventions have been shown to improve the health of children and reduce mortality. These include promotion of exclusive breast feeding for the first 6 months of life, immunisation and utilisation of available newborn healthcare services, which are proven to improve newborn survival. This study aims to determine the impact of a behaviour change intervention that partners Orthodox priests with volunteer community health workers, known in Ethiopia as the Health Development Army and trains them to conduct newborn health outreach to improve care seeking, uptake of key interventions and identification of sick infants.

METHODS

The study designed is a community-randomised trial conducted in the Central Gondar area. The behaviour change intervention pairs trained Orthodox priests with members of the Health Development Army to conduct community health outreach by identifying near-term pregnant women in their communities and educating them on the topics of exclusive breast feeding, immunisation, nutrition and uptake of available child healthcare services. The evaluation of the intervention will enrol up to 150 newborn-mother pairs from communities receiving the behaviour change intervention and another 150 pairs enrolled from control communities. The quantitative analysis will be done by comparing data between the intervention and control groups related to breast feeding, anthropometry, immunisation status and uptake of child health services. The primary outcomes are exclusive breastfeeding through 6 months, mid-upper arm circumference, completion of vaccinations and infant hospitalisation.

ETHICS AND DISSEMINATION

Ethical approval has been obtained from the University of Washington (STUDY00006942) and the University of Gondar (No.V/P/RCS/05/2523/2019) Institutional Review Boards. Oral consent was obtained for the formative study, whereas written consent (or witnessed thumbprint) will be obtained from all enrolled mothers. Results will be communicated to community members, relevant government agencies and other stakeholders.

TRIAL REGISTRATION NUMBER

NCT05111899.

© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Address: College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.; Global Health, University of Washington, Seattle, Washington, USA.; Epidemiology, University of Washington, Seattle, Washington, USA.; Medicine, University of Washington, Seattle, Washington, USA.; Departments of International Health, Medicine and Pediatrics, Johns Hopkins University, Baltimore, Maryland, USA.; Global Health, University of Washington, Seattle, Washington, USA.; University of Washington, Seattle, Washington, USA.; Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia.; Epidemology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia.; Global Health, University of Washington, Seattle, Washington, USA [email protected].; Epidemiology, University of Washington, Seattle, Washington, USA.
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