Worldwide, many newborns die in the first month of life, with most deaths happening in low/middle-income countries (LMICs). Families’ use of evidence-based newborn care practices in the home and timely care-seeking for illness can save newborn lives. Postnatal education is an important investment to improve families’ use of evidence-based newborn care practices, yet there are gaps in the literature on postnatal education programees that have been evaluated to date. Recent findings from a 13 000+ person survey in 3 states in India show opportunities for improvement in postnatal education for mothers and families and their use of newborn care practices in the home. Our survey data and the literature suggest the need to incorporate the following strategies into future postnatal education programming: implement structured predischarge education with postdischarge reinforcement, using a multipronged teaching approach to reach whole families with education on multiple newborn care practices. Researchers need to conduct robust evaluation on postnatal education models incorporating these programee elements in the LMIC context, as well as explore whether this type of education model can work for other health areas that are critical for families to survive and thrive.

Background and objectivesThe Care Companion Program (CCP) is an in-hospital multitopic skill-based training programme provided to families to improve postdischarge maternal and neonatal health. The states of Punjab and Karnataka in India piloted the programme in 12 district hospitals in July 2017, and no study to date has evaluated its impact.MethodsWe compared telephonically self-reported maternal and neonatal care practices and health outcomes before and after the launch of the CCP programme in 11 facilities. Families in the preintervention group delivered between May to June 2017 (N=1474) while those in the intervention group delivered between August and October 2017 (N=3510). Programme effects were expressed as adjusted risk ratios obtained from logistic regression models.ResultsAt 2-week postdelivery, the practice of dry cord care improved by 4% (RR=1.04, 95% CI 1.02 to 1.06) and skin-to-skin care by 78% (RR=1.78, 95% CI 1.37 to 2.27) in the postintervention group as compared with preintervention group. Furthermore, newborn complications reduced by 16% (RR=0.84, 95% CI 0.76 to 0.91), mother complications by 12% (RR=0.88, 95% CI 0.79 to 0.97) and newborn readmissions by 56% (RR=0.44, 95% CI 0.31 to 0.61). Outpatient visits increased by 27% (RR=1.27, 95% CI 1.10 to 1.46). However, the practice of exclusive breastfeeding, unrestricted maternal diet, hand-hygiene and being instructed on warning signs were not statistically different.ConclusionPostnatal care should incorporate predischarge training of families. Our findings demonstrate that it is possible to improve maternal and neonatal care practices and outcomes through a family-centered programme integrated into public health facilities in low and middle-income countries.

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Back Background ground Patient and family caregiver education is essential for adequate home care after a cardiothoracic surgical intervention. In resource-poor settings where access to medical care is limited and health literacy is low, pre-discharge caregiver education is frequently overlooked. This study evaluates the effect of the Care Companion Program (CCP), an in-hospital patient family engagement and education program that targets family caregivers to support post-surgical patient recovery. Methods Methods This study was based on a quasi-experimental design at a tertiary care facility in Kolkata, India, in which 188 patient-caregiver dyads providing support to patients undergoing surgical intervention for cardiovascular disease were selected to participate. One hundred dyads received standard of care (SoC), and 88 dyads received the CCP. Patient-caregiver dyads were evaluated on patient post-discharge complications and physical functional status; Caregiver Activation Measure and health knowledge. Assessments were conducted at baseline, discharge, and post-discharge at 30 days. R Results esults Post-discharge 30-day complication rates were significantly lower for the CCP group compared to SoC (34.4% vs. 14.5%, respectively, P0.003). The CCP group showed a significantly greater increase in their Caregiver Activation Measure scores between baseline and discharge (4.2 ± 9.1 vs. 1.3 ± 7.4, respectively, P<0.001) that were sustained at 30 days post-discharge (7.2 ± 17.4 vs. 1.4 ± 10.4, respectively, P<0.001). Knowledge scores for the CCP group showed significant improvement (P<0.001) between baseline and discharge and were sustained at 30 days post-discharge (P0.003). Compared to the SoC group, patients in the CCP group reported a significantly greater increase in their physical functional status (World Health Organization Quality of Life short form assessment (WHOQOL-BREF) physical health domain) between baseline and 30 days post-discharge (P=0.018). C Conclusions onclusions The results of the study suggest significant associations between participation in the CCP and reduced 30-day complications, increased caregiver activation, and increases in health knowledge. Programs such as the CCP may play an important role in engaging family caregivers to improve health outcomes in settings with limited healthcare resources. Family caregivers play an essential role in the successful recovery of hospitalized patients by serving as the primary care providers following hospital stays. Integrating patient families as part of the care team can result in cost savings, enhanced patient and family experience of care, improved acute disease management, enhanced continuity of care,

Despite the global decline, neonatal mortality rates (NMR) remain high in India. Family members are often responsible for the postpartum care of neonates and mothers. Yet, low health literacy and varied beliefs can lead to poor health outcomes. Postpartum education for family caregivers, may improve the adoption of evidence-based neonatal care and health outcomes. The Care Companion Program (CCP) is a hospital-based, pre-discharge health training session where nurses teach key healthy behaviors to mothers and family members, including skills and an opportunity to practice them in the hospital. We conducted a quasi-experimental study to assess the effect of the CCP sessions on mortality outcomes among families seeking care in 28 public tertiary facilities across 4 Indian states. Neonatal mortality outcomes were reported post-discharge, collected via phone surveys at four weeks postpartum, between October 2018 to February 2020. Risk ratios (RR), adjusting for hospital-level clustering, were calculated by comparing mortality rates before and after CCP implementation. A total of 46,428 families participated in the pre-intervention group and 87,305 in the post-intervention group; 76% of families completed the phone survey. Among the 33,599 newborns born before the CCP implementation, there were 1386 deaths (NMR: 41.3 deaths per 1000 live births). After the intervention began, there were 2021 deaths out of 60,078 newborns born (crude NMR: 33.6 deaths per 1000 live births, RR = 0.82, 95% CI: 0.76, 0.87; cluster-adjusted RR = 0.82, 95% CI: 0.71, 0.94). There may be a substantial benefit to family-centered education in the early postnatal period to reduce neonatal mortality.