Evidence map›Paper›PMID 32838701›Full record

Trial reportGlobal health action2020

Effect of an integrated neonatal care kit on cause-specific neonatal mortality in rural Pakistan.

Jessica Duby, Lisa G Pell, Shabina Ariff, Amira Khan, Afsah Bhutta, Daniel S Farrar, Diego G Bassani, Masawar Hussain, Zulfiqar A Bhutta, Sajid Soofi and 1 more

Open access · goldAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Global health action, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Jessica DubyDepartment of Pediatrics, McGill University , Montreal, Canada.ORCID 0000-0003-4321-0844
Lisa G PellCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.ORCID 0000-0001-5116-9998
Shabina AriffCenter of Excellence in Women and Child Health, The Aga Khan University , Karachi, Pakistan.ORCID 0000-0002-9627-2662
Amira KhanCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.
Afsah BhuttaCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.ORCID 0000-0003-0637-599X
Daniel S FarrarCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.ORCID 0000-0002-7823-1912
Diego G BassaniCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.ORCID 0000-0001-6704-3820
Masawar HussainCenter of Excellence in Women and Child Health, The Aga Khan University , Karachi, Pakistan.
Zulfiqar A BhuttaCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.
Sajid SoofiCenter of Excellence in Women and Child Health, The Aga Khan University , Karachi, Pakistan.ORCID 0000-0003-4192-8406
Shaun K MorrisCentre for Global Child Health, The Hospital for Sick Children , Toronto, Canada.ORCID 0000-0001-9809-0822
Aga Khan University · PKHospital for Sick Children · CAUniversity of Toronto · CAMcGill University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2018, Pakistan had the world's highest neonatal mortality rate. Within Pakistan, most neonatal deaths occur in rural areas where access to health facilities is limited, and robust vital registration systems are lacking. To improve newborn survival, there is a need to better understand the causes of neonatal death in high burden settings and engage caregivers in the promotion of newborn health.

objectiveTo describe the causes of neonatal death in a rural area in Pakistan and to estimate the effect of an integrated neonatal care kit (iNCK) on cause-specific neonatal mortality.

methodsWe analyzed data from a community-based, cluster-randomized controlled trial of 5286 neonates in Rahim Yar Khan (RYK), Punjab, Pakistan between April 2014 and August 2015. In intervention clusters, Lady Health Workers (LHW) delivered the iNCK and education on its use to pregnant women while control clusters received the local standard of care. The iNCK included interventions to prevent and identify signs of infection, identify low birthweight (LBW), and identify and manage hypothermia. Verbal autopsies were attempted for all deaths. The primary outcome was cause-specific neonatal mortality.

resultsVerbal autopsies were conducted for 84 (57%) of the 147 reported neonatal deaths. The leading causes of death were infection (44%), intrapartum-related complications (26%) and prematurity/LBW (20%). There were no significant differences in neonatal mortality due to prematurity/LBW (RR 0.43; 95% CI 0.15-1.24), infection (RR 1.10; 95% CI 0.58-2.10) or intrapartum-related complications (RR 1.04; 95% CI 0.0.45-2.41) among neonates who died in the intervention arm compared to those who died in the control arm.

conclusionThe major causes of neonatal deaths in RYK, Pakistan mirror the global landscape of neonatal deaths. The iNCK did not significantly reduce any cause-specific neonatal mortality.

Indexed as

Cause of DeathInfant MortalityAutopsyCommunity Health WorkersFemaleHumansInfantInfant, NewbornPakistanPregnancyPrenatal CareRural Populationcause of deathcommunity health workersNewbornpakistanverbal autopsy

Identifiers

PMID32838701
PMCPMC7480452
OpenAlexW3081216388

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.