Trial reportBMJ (Clinical research ed.)2011
Effect of training traditional birth attendants on neonatal mortality (Lufwanyama Neonatal Survival Project): randomised controlled study.
Trial report in BMJ (Clinical research ed.), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00518856 (Lufwanyama Neonatal Survival Project), which is not on this map. Cited by 82 papers, 23 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.
Lufwanyama Neonatal Survival Project
Who cites it
82 citing papers in PubMed, 23 syntheses or guidelines pooled it.
- Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants.The Cochrane database of systematic reviews · 2026Pooled it
- Pooled it
- Prevention and Treatment of Neonatal Infections in Facility and Community Settings of Low- and Middle-Income Countries: A Descriptive Review.Neonatology · 2025Pooled it
- Effectiveness of Neonatal Resuscitation Training Programs, Implementation, and Scale-Up in Low- and Middle-Income Countries.Neonatology · 2025Pooled it
- Simulation-Based Education of Health Workers in Low- and Middle-Income Countries: A Systematic Review.Global health, science and practice · 2024Pooled it
- Maternal and Child Health Training of Traditional Birth Attendants and Pregnancy Outcomes: A Systematic Review and Meta-analysis.Journal of epidemiology and global health · 2024Pooled it
- Integrated community case management of childhood illness in low- and middle-income countries.The Cochrane database of systematic reviews · 2021Pooled it
- Community-based maternal and newborn educational care packages for improving neonatal health and survival in low- and middle-income countries.The Cochrane database of systematic reviews · 2019Pooled it
- Community-based antibiotic delivery for possible serious bacterial infections in neonates in low- and middle-income countries.The Cochrane database of systematic reviews · 2019Pooled it
- Home-based neonatal care by community health workers for preventing mortality in neonates in low- and middle-income countries: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2016Pooled it
- When do newborns die? A systematic review of timing of overall and cause-specific neonatal deaths in developing countries.Journal of perinatology : official journal of the California Perinatal Association · 2016Pooled it
- Cost and cost-effectiveness of newborn home visits: findings from the Newhints cluster-randomised controlled trial in rural Ghana.The Lancet. Global health · 2016Pooled it
- Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review.Health policy and planning · 2015Pooled it
- Standardised formal resuscitation training programmes for reducing mortality and morbidity in newborn infants.The Cochrane database of systematic reviews · 2015Pooled it
- In-service training for health professionals to improve care of seriously ill newborns and children in low-income countries.The Cochrane database of systematic reviews · 2015Pooled it
- Community-based intervention packages for reducing maternal and neonatal morbidity and mortality and improving neonatal outcomes.The Cochrane database of systematic reviews · 2015Pooled it
- Pooled it
- Estimates of possible severe bacterial infection in neonates in sub-Saharan Africa, south Asia, and Latin America for 2012: a systematic review and meta-analysis.The Lancet. Infectious diseases · 2014Pooled it
- The global burden of neonatal hypothermia: systematic review of a major challenge for newborn survival.BMC medicine · 2013Pooled it
- Traditional birth attendant training for improving health behaviours and pregnancy outcomes.The Cochrane database of systematic reviews · 2012Pooled it
22 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
15 authors.
Funding
Abstract
objectiveTo determine whether training traditional birth attendants to manage several common perinatal conditions could reduce neonatal mortality in the setting of a resource poor country with limited access to healthcare.
designProspective, cluster randomised and controlled effectiveness study.
settingLufwanyama, an agrarian, poorly developed district located in the Copperbelt province, Zambia. All births carried out by study birth attendants occurred at mothers' homes, in rural village settings.
participants127 traditional birth attendants and mothers and their newborns (3559 infants delivered regardless of vital status) from Lufwanyama district.
interventionsUsing an unblinded design, birth attendants were cluster randomised to intervention or control groups. The intervention had two components: training in a modified version of the neonatal resuscitation protocol, and single dose amoxicillin coupled with facilitated referral of infants to a health centre. Control birth attendants continued their existing standard of care (basic obstetric skills and use of clean delivery kits).
main outcome measuresThe primary outcome was the proportion of liveborn infants who died by day 28 after birth, with rate ratios statistically adjusted for clustering. Secondary outcomes were mortality at different time points; and comparison of causes of death based on verbal autopsy data.
resultsAmong 3497 deliveries with reliable information, mortality at day 28 after birth was 45% lower among liveborn infants delivered by intervention birth attendants than control birth attendants (rate ratio 0.55, 95% confidence interval 0.33 to 0.90). The greatest reductions in mortality were in the first 24 hours after birth: 7.8 deaths per 1000 live births for infants delivered by intervention birth attendants compared with 19.9 per 1000 for infants delivered by control birth attendants (0.40, 0.19 to 0.83). Deaths due to birth asphyxia were reduced by 63% among infants delivered by intervention birth attendants (0.37, 0.17 to 0.81) and by 81% within the first two days after birth (0.19, 0.07 to 0.52). Stillbirths and deaths from serious infection occurred at similar rates in both groups.
conclusionsTraining traditional birth attendants to manage common perinatal conditions significantly reduced neonatal mortality in a rural African setting. This approach has high potential to be applied to similar settings with dispersed rural populations. Trial registration Clinicaltrials.gov NCT00518856.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.