Trial reportArchives of pediatrics & adolescent medicine2008
Maternal and birth attendant hand washing and neonatal mortality in southern Nepal.
Trial report in Archives of pediatrics & adolescent medicine, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00109616 (Newborn Antiseptic Washing and Neonatal Mortality-Nepal), which is not on this map. Cited by 45 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Newborn Antiseptic Washing and Neonatal Mortality-Nepal
Who cites it
45 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Impact on childhood mortality of interventions to improve drinking water, sanitation, and hygiene (WASH) to households: Systematic review and meta-analysis.PLoS medicine · 2023Pooled it
- Hand hygiene for the prevention of infections in neonates.The Cochrane database of systematic reviews · 2021Pooled it
- Clean birth and postnatal care practices to reduce neonatal deaths from sepsis and tetanus: a systematic review and Delphi estimation of mortality effect.BMC public health · 2011Pooled it
- Waterless Hand Cleansing with Chlorhexidine during the Neonatal Period by Mothers and Other Household Members: Findings from a Randomized Controlled Trial.The American journal of tropical medicine and hygiene · 2020Trial
- A Linked Community and Health Facility Intervention to Improve Newborn Health in Cambodia: the NICCI Stepped-Wedge Cluster-Randomized Controlled Trial.International journal of environmental research and public health · 2020Trial
- Evaluation of the impact of antimicrobial hand towels on hand contamination with Escherichia coli among mothers in Kisumu County, Kenya, 2011-2012.Water research · 2019Trial
- Impact of an Intensive Perinatal Handwashing Promotion Intervention on Maternal Handwashing Behavior in the Neonatal Period: Findings from a Randomized Controlled Trial in Rural Bangladesh.BioMed research international · 2017Trial
- Impact of regular soap provision to primary schools on hand washing and E. coli hand contamination among pupils in Nyanza Province, Kenya: a cluster-randomized trial.The American journal of tropical medicine and hygiene · 2013Trial
- A large cross-sectional community-based study of newborn care practices in southern Tanzania.PloS one · 2010Trial
- Impact of the integration of water treatment and handwashing incentives with antenatal services on hygiene practices of pregnant women in Malawi.The American journal of tropical medicine and hygiene · 2010Trial
- From parental education to under-5 mortality: how antenatal care and hand hygiene mediate the pathway mechanisms.BMC public health · 2025Article
- Hand hygiene for the prevention of infections in neonates.The Cochrane database of systematic reviews · 2023Review
- A controlled before-and-after study of a multi-modal intervention to improve hand hygiene during the peri-natal period in Cambodia.Scientific reports · 2022Article
- Diarrhoea among Children Under Five Years of Age Residing in a Village Development Committee: A Descriptive Cross-sectional Study.JNMA; journal of the Nepal Medical Association · 2022Article
- Time to under-five mortality and its predictors in rural Ethiopia: Cox-gamma shared frailty model.PloS one · 2022Article
- Interventions promoting uptake of water, sanitation and hygiene (WASH) technologies in low- and middle-income countries: An evidence and gap map of effectiveness studies.Campbell systematic reviews · 2021Article
- Pattern, predictors and clustering of handwashing practices in India.Journal of infection prevention · 2021Article
- Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia.International journal of environmental research and public health · 2021Observational
- Hygiene along the continuum of care in the early post-natal period: an observational study in Nigeria.BMC pregnancy and childbirth · 2020Observational
- Determinants of clean birthing practices in low- and middle-income countries: a scoping review.BMC public health · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundMore than 95% of neonatal deaths occur in developing countries, approximately 50% at home. Few data are available on the impact of hand-washing practices by birth attendants or caretakers on neonatal mortality.
objectiveTo evaluate the relationship between birth attendant and maternal hand-washing practices and neonatal mortality in rural Nepal.
designObservational prospective cohort study.
settingSarlahi District in rural southern Nepal.
participantsNewborn infants were originally enrolled in a community-based trial assessing the effect of skin and/or umbilical cord cleansing with chlorhexidine on neonatal mortality in southern Nepal. A total of 23,662 newborns were enrolled and observed through 28 days of life. MAIN EXPOSURES: Questionnaires were administered to mothers on days 1 and 14 after delivery to identify care practices and risk factors for mortality and infection. Three hand-washing categories were defined: (1) birth attendant hand washing with soap and water before assisting with delivery, (2) maternal hand washing with soap and water or antiseptic before handling the baby, and (3) combined birth attendant and maternal hand washing. OUTCOME MEASURES: Mortality within the neonatal period.
resultsBirth attendant hand washing was related to a statistically significant lower mortality rate among neonates (adjusted relative risk [RR] = 0.81; 95% confidence interval [CI], 0.66-0.99), as was maternal hand washing (adjusted RR = 0.56; 95% CI, 0.38-0.82). There was a 41% lower mortality rate among neonates exposed to both hand-washing practices (adjusted RR = 0.59; 95% CI, 0.37-0.94).
conclusionsBirth attendant and maternal hand washing with soap and water were associated with significantly lower rates of neonatal mortality. Measures to improve or promote birth attendant and maternal hand washing could improve neonatal survival rates.
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