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Table 1 Proposed actions during home visits by community health workers

From: The Uganda Newborn Study (UNEST): an effectiveness study on improving newborn health and survival in rural Uganda through a community-based intervention linked to health facilities - study protocol for a cluster randomized controlled trial

Two visits during pregnancy (ANC)
Focus of pregnancy visit 1 (as early as possible or in second trimester)
Counsel on and refer for ANC including TT, IPT and ITNs
Counsel on birth preparedness and use of clean delivery practices
Assess and counsel on danger signs of pregnancy
Counsel on and refer for HIV testing for PMTCT
Focus of pregnancy visit 2 (in third trimester)
Counsel on birth preparedness
Assess for maternal danger signs and refer if present
Counsel on clean delivery practices
Counsel on immediate maternal newborn and newborn care practices
Counsel on newborn danger signs
Three visits after pregnancy (PNC)
Postnatal visit 1: birthday to day 2
Screen for and counsel on maternal and newborn danger signs and refer if present
Take newborn’s temperature, weight and respiratory rate
Support temperature management (skin-to-skin for all babies, delayed bathing, and wrapping)
Support immediate and exclusive breastfeeding
Encourage cleanliness especially cord care
Postnatal visit 2: day 3 after birth
Assess for maternal and newborn danger signs and refer if necessary
Refer for immunization
Counsel mother on breastfeeding and birth spacing
Reinforce need to seek care/call CHW for signs of local infection or danger signs
Postnatal visit 3: day 5 to 7 after birth
Assess for maternal and newborn danger signs and refer if necessary
Refer for immunization
Counsel mother on breastfeeding and birth spacing
Reinforce need to seek care/call CHW for signs of local infection or danger signs
Promote access to under five clinics and family planning at six weeks
If very low birth weight suspected 1
Refer if also danger sign present or two extra visits to support home care (breastfeeding, warmth, early danger sign recognition) if no danger sign or referral not possible
Promote temperature management (skin-to-skin, wrapping and delayed bathing)
Assist with feeding if needed
Attention to hygiene
Additional home visits: when called by caretakers
Check for signs of local infection and danger signs
Give early treatment (tentatively cotrimoxazole) and arrange facilitated referral
  1. 1In Ghana, maternal sensitivity was 73% and specificity 93% to detect birth weight <2 kg. Source: Final Report of the NEWHINTS Formative Research. ANC, antenatal care; IPT, intermittent presumptive treatment; ITN, insecticide-treated net; PMTCT, preventing mother-to-child transmission; PNC, postnatal care; TT, tetanus toxoid immunization.