Intervention | Cause of death addressed | Behaviour addressed |
---|---|---|
Community worker: pregnancy visit 1 and 2 | ||
Community health worker: pregnancy visit | Â | Â |
• Counsel on and refer for ANC including TT, IPT and ITNs | • Neonatal tetanus, risk associated w/ maternal malaria | • Low four-visit ANC rate, low malaria treatment rate |
• Counsel on birth preparedness and use of clean delivery practices | • All causes | • Poor delivery practices |
• Assess and counsel on danger signs of pregnancy | • Prematurity, infection | • Low HF use rate for emergencies |
• Counsel on and refer for HIV testing for PMTCT | • HIV/AIDs transmission | • Lack of understanding of HIV/AIDs |
• Introduce key neonatal behaviours such as immediate initiation of breastfeeding, delayed bathing, immediate wrapping, skin and cord hygiene, and skin-to-skin care | • All causes | • Poor delivery practices |
Pregnancy visit 2 | ||
• Counsel on birth preparedness | • Infection | • Low HF use, lack of awareness |
• Assess for maternal danger signs and refer if present | • All causes | • As above |
• Counsel on clean delivery practices | • Infection | • Lack of awareness |
• Counsel on immediate maternal and newborn care practices |  | • Lack of awareness |
• Counsel on newborn danger signs |  |  |
Community worker: postnatal visit 1 and 2 | ||
Postnatal visit 1: birthday to day 2 | ||
• Screen for and counsel on maternal and newborn danger signs and refer if present | • Prematurity, infection | • Lack of HF use, lack of awareness |
• Support temperature management (skin-to-skin for all babies, delayed bathing, and wrapping) | • Risk from low birth weight, infection | • Lack of HF use |
• Support immediate and exclusive breastfeeding | • Hypothermia | • Low HF use for deliveries |
• Encourage cleanliness especially cord care | • Overall risk, infection | • Lack of compliance |
 | • Infection | • Low HF use for deliveries |
 | • Prematurity, infection | • Low awareness |
 | • Hypothermia, infection | • Low HF use for deliveries, awareness |
 | • Risk from immunizable diseases | • Low TT and other EPI rates |
 | • Overall risk, infection | • As above |
Postnatal visit 2 and 3: day 3 and day 5 and 7 after birth | ||
• Assess for maternal and newborn danger signs and refer if necessary |  |  |
• Refer for immunization |  |  |
• Counsel mother on breastfeeding and birth spacing |  |  |
If very low birth weight suspected 1 | ||
• Refer if also danger sign present or two extra visits to support home care (breast-feeding, 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 |  |  |
Health facility strengthening | ||
• Training | • Sepsis | • Poor quality of care, low HF use for deliveries, inadequate equipment |
• Provision of supplies and medicines | • Sepsis | |
• Improved sepsis management at lower HF | • Sepsis | |
• Supervision and monitoring | • Overall risk |