Cleansing a newborn’s umbilical cord with an antiseptic can reduce the risk of infection and death, according to a study by Aga Khan University’s Division of Women and Child Health (DWCH).
The research, published in the medical journal The Lancet, was conducted in 1,300 villages in Dadu district.
With 53 deaths per 10,000 live births, Pakistan has one of the highest newborn mortality rates in the world, with almost a third of them due to infections. Infection risk to the infant is greatest in countries where most deliveries are completed by unskilled attendants at the woman’s home. Unsafe practices like cutting the birth cord with unsterilised materials, and the application of substances such as ash, surma (lead-based concoction), oil and even cow dung are common in many rural areas of Pakistan.
The study followed nearly 10,000 newborns between January 2008 and June 2009, and looked at the effectiveness of three different strategies. The first consisted of using birth kits that contained four per cent chlorhexidine (CHX), which were applied to the cord at birth and then once daily for the next 14 days, along with encouraging the family to regularly wash the infant’s hands with soap.
The second involved the use of CHX alone, while the third involved encouraging hand washing only. The fourth group was advised to practice the standard dry cord care procedures recommended by the World Health Organisation.
The study showed that cord cleansing with CHX reduced the risk of infection in children by 42 per cent and deaths by 38 per cent. The hand washing promotion by itself appeared to have no effect on infection or mortality risk.
“Given the large number of newborn deaths that occur due to severe infection in home settings, our study not only provides evidence that a simple low-cost solution like chlorhexidine can save lives, but also shows that a delivery strategy through packaging birth kits works,” said Prof Dr Zulfiqar A Bhutta, the head of the DWCH and principal investigator of the study.
“It could be used to scale up coverage of these interventions at birth in both community settings and public sector facilities. These findings also have substantial implications for public health in South Asia, where many areas share similar cultural, social, and economic characteristics.”
Researchers propose that this intervention be considered for possible inclusion in range of interventions available to lady health workers of the National Programme for Family Planning and Primary Care.
Dadu has a population of about one million, and an infant mortality rate of 90 per 1,000 live births. The study was funded by Pakistan Initiative for Mothers and Newborns, and John Snow Inc. via a grant by the US Agency for International Development.
Published in The Express Tribune, February 9th, 2012.
COMMENTS (1)
Comments are moderated and generally will be posted if they are on-topic and not abusive.
For more information, please see our Comments FAQ
A highly critical topic to save lives, all of the above mentioned plans are crucial for the infants life and must be implemented as soon as possible with full force.