Observational studyBMC pregnancy and childbirth2021
Immediate newborn care and breastfeeding: EN-BIRTH multi-country validation study.
Observational study in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
What it found
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Who cites it
22 citing papers in PubMed, 28 citations in OpenAlex.
- The Global Maternal and Newborn Health Platform: study protocol for an observational, multi-country study on the quality of intrapartum and early postnatal care at health facilities.BMC public health · 2026Observational
- Association of early initiation of breastfeeding on postpartum depression-multi-centric longitudinal cohort study in Nepal.Frontiers in global women's health · 2026Article
- Availability and the quality of key newborn data within routine health facility data: findings of the IMPULSE observational study in the Central African Republic, Ethiopia, Tanzania, and Uganda.Journal of global health · 2025Observational
- Measuring respectful maternal and newborn care in Nepal: Comparing linked observation and interview data- prospective cohort study.PLOS global public health · 2025Article
- The Impact of Mode of Delivery and Postpartum Conditions on Breastfeeding: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2024Article
- How and why does mode of birth affect processes for routine data collection and use? A qualitative study in Bangladesh and Tanzania.PLOS global public health · 2024Article
- Article
- Safety and Feasibility of Skin-to-Skin Contact in the Delivery Room for High-Risk Cardiac Neonates.Pediatric cardiology · 2023Article
- Prevalence of essential newborn care in home and facility births in the Peruvian Amazon: analysis of census data from programme evaluation in three remote districts of the Loreto region.Lancet regional health. Americas · 2023Article
- Timing of perinatal death; causes, circumstances, and regional variations among reviewed deaths in Ethiopia.PloS one · 2023Article
- Article
- Adherence to Optimal Breastfeeding Practices Among HIV-Positive Mothers in Kilimanjaro, Tanzania.Patient preference and adherence · 2022Article
- Household Survey Measurement of Newborn Postnatal Care: Coverage, Quality Gaps, and Internal Inconsistencies in Responses.Global health, science and practice · 2021Article
- Predictors for timely initiation of breastfeeding after birth in the hospitals of Nepal- a prospective observational study.International breastfeeding journal · 2021Observational
- Initiation of Breastfeeding in Low- and Middle-Income Countries: A Time-to-Event Analysis.Global health, science and practice · 2021Article
- Equity in newborn care, evidence from national surveys in low- and middle-income countries.International journal for equity in health · 2021Article
- Count every newborn: EN-BIRTH study improving facility-based coverage and quality measurement in routine information systems.BMC pregnancy and childbirth · 2021Article
- Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences.BMC pregnancy and childbirth · 2021Observational
- Chlorhexidine for facility-based umbilical cord care: EN-BIRTH multi-country validation study.BMC pregnancy and childbirth · 2021Observational
- Respectful maternal and newborn care: measurement in one EN-BIRTH study hospital in Nepal.BMC pregnancy and childbirth · 2021Observational
Corrections and comments
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Authors and funding
19 authors at 6 institutions in 6 countries.
Funding
Abstract
backgroundImmediate newborn care (INC) practices, notably early initiation of breastfeeding (EIBF), are fundamental for newborn health. However, coverage tracking currently relies on household survey data in many settings. "Every Newborn Birth Indicators Research Tracking in Hospitals" (EN-BIRTH) was an observational study validating selected maternal and newborn health indicators. This paper reports results for EIBF.
methodsThe EN-BIRTH study was conducted in five public hospitals in Bangladesh, Nepal, and Tanzania, from July 2017 to July 2018. Clinical observers collected tablet-based, time-stamped data on EIBF and INC practices (skin-to-skin within 1 h of birth, drying, and delayed cord clamping). To assess validity of EIBF measurement, we compared observation as gold standard to register records and women's exit-interview survey reports. Percent agreement was used to assess agreement between EIBF and INC practices. Kaplan Meier survival curves showed timing. Qualitative interviews were conducted to explore barriers/enablers to register recording.
resultsCoverage of EIBF among 7802 newborns observed for ≥1 h was low (10.9, 95% CI 3.8-21.0). Survey-reported (53.2, 95% CI 39.4-66.8) and register-recorded results (85.9, 95% CI 58.1-99.6) overestimated coverage compared to observed levels across all hospitals. Registers did not capture other INC practices apart from breastfeeding. Agreement of EIBF with other INC practices was high for skin-to-skin (69.5-93.9%) at four sites, but fair/poor for delayed cord-clamping (47.3-73.5%) and drying (7.3-29.0%). EIBF and skin-to-skin were the most delayed and EIBF rarely happened after caesarean section (0.5-3.6%). Qualitative findings suggested that focusing on accuracy, as well as completeness, contributes to higher quality with register reporting.
conclusionsOur study highlights the importance of tracking EIBF despite measurement challenges and found low coverage levels, particularly after caesarean births. Both survey-reported and register-recorded data over-estimated coverage. EIBF had a strong agreement with skin-to-skin but is not a simple tracer for other INC indicators. Other INC practices are challenging to measure in surveys, not included in registers, and are likely to require special studies or audits. Continued focus on EIBF is crucial to inform efforts to improve provider practices and increase coverage. Investment and innovation are required to improve measurement.
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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.