Impact of family-centred postnatal training on maternal and neonatal health and care practices in district hospitals in two states in India: a pre–post study

Kashyap, Sehj; Spielman, Amanda; Ramnarayan, Nikhil; Sd, Sahana; Pant, Rashmi; Kaur, Baljit; Rajkumar, N. Vimal; Premkumar, Ramaswamy; Singh, Tanmay; Pratap, Bhanu; Kumar, Anand; Alam, Shahed; Murthy, Seema

doi:10.1136/bmjoq-2021-001462

Cited by 7 publications

(10 citation statements)

References 11 publications

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“…These qualitative results completement a previous pilot evaluation of CCP in Punjab and Karnataka, which reported statistically significant improvements on dry cord care practice by 4%, skin-to-skin care by 78%, newborn complications reduced by 16%, mother complications by 12%, and newborn readmissions by 56% in the postintervention group as compared with preintervention group [30]. However, the practice of exclusive breastfeeding, unrestricted maternal diet, hand-hygiene and being instructed on warning signs were not statistically different.…”

Section: Discussionsupporting

confidence: 78%

Qualitative assessment of family caregiver-centered neonatal education program in Karnataka, India

Yan¹,

S.D.²,

Desai

et al. 2023

PLOS Glob Public Health

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Globally 2.5 million newborns die every year before they reach the age of one month; the majority of these deaths occur in low- and middle-income countries. Among other factors, inadequate knowledge and skills to take care of newborns contribute to these deaths. To fill this gap, training patients and family members on the behaviors needed to improve essential newborn care practices at home is a promising opportunity. One program that aims to do this is the Care Companion Program (CCP) which provides in-hospital, skills-based training on care of mothers and newborns to families. This study uses semi-structured interviews to understand how and why knowledge and behaviors of maternal and newborn care behaviors change (or don’t change) as a result of CCP sessions and participants’ perception of the impact of CCP on change. Interviews focused on knowledge and behaviors around key neonatal and newborn topics and health seeking behaviors for health complications. Forty-two in-depth interviews were conducted among families with recently-delivered babies at their homes from four districts in Karnataka, India. Respondents have a positive perception about CCP, found training useful and appreciated other family members presence during the training. CCP increased knowledge and awareness and provided critical details to key behaviors like breastfeeding. Respondents were more likely to be receptive toward details on already known topics, like hand washing before touching the baby. Awareness increased on newly learned behaviors, like skin-to-skin care, which don’t conflict with cultural norms. The CCP did not influence nonrestrictive maternal diet as much, which cultural norms heavily influence. In-hospital family caregiver education programs, like CCP, can positively influence key neonatal behaviors by imparting knowledge and key skills. However, the effect is not universal across health behaviors.

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Section: Discussionsupporting

confidence: 78%

Qualitative assessment of family caregiver-centered neonatal education program in Karnataka, India

Yan¹,

S.D.²,

Desai

et al. 2023

PLOS Glob Public Health

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“…Training physicians and nurses on delivering important medical information to patients as well as educating patients and caregivers are two key components of FCC (16). FCC-based interventions have resulted in positive health outcomes in several conditions (13,(17)(18)(19). Promotion of antenatal care and maternal health education is given to mothers and caregivers to improve key behaviors resulting in positive health outcomes (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

“…Promotion of antenatal care and maternal health education is given to mothers and caregivers to improve key behaviors resulting in positive health outcomes (20)(21)(22). Hospital-based FCC interventions focusing on awareness and improving the skills of parents and caregivers can be helpful in improving key behaviors and postnatal outcomes (13). Similarly, FCC-based community interventions include sociocultural appropriate behavior modification techniques such as delivering health education and information to parents and caregivers, training birth attendants on identifying early danger signs, and training community health workers as master trainers to further train the family members on risky maternal and newborn care practices were expected to reduce the neonatal mortality and morbidity burden on health systems (22,23).…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, families receive post-discharge follow-up through a dedicated WhatsApp-based platform, which reiterates key behavior change messages, and allows for two-way communication, providing families the opportunity to ask questions and receive guidance. Initial findings showed promising results for increased behavior change, and reduction in preventable complications and readmissions (13).…”

Section: Introductionmentioning

confidence: 99%

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Improving newborn health with family-centered, early postnatal care: a quasi-experimental study

Murthy¹,

Yan²,

Alam³

et al. 2022

Preprint

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Despite the recent decline, neonatal mortality rates (NMR) remain high in India. Family members are often responsible for the postpartum care of newborns and mothers. Yet, low health literacy and varied beliefs can lead to poor neonatal health outcomes. Postpartum education for family caregivers can improve the adoption of evidence-based newborn care and health outcomes. The Care Companion Program (CCP) is a hospital-based, pre-discharge health training session where nurses teach key healthy behaviors and help mothers and family members learn skills and practice in the hospital. Here, we assessed the impact of CCP on NMR. 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 of age of baby, 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 participated in the phone survey. The crude NMR was 33.64 deaths per 1000 live births (RR=0.82, 95% CI: 0.76, 0.87). After accounting for hospital-clustering, the NMR was 41.3 (adjusted RR=0.81, 95% CI: 0.71, 0.93). There may be a substantial benefit to family-centered education in the early postnatal period to reduce neonatal mortality.

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“…This intervention has demonstrated efficacy across different conditions, showing a reduction in post-surgical cardiac complications by 71%, 7 maternal complications by 12%, newborn complications by 16% and newborn readmissions by 56%. 8 COVID-19 precautions and restrictions necessitated a telephonic method of deploying the CCP.…”

Section: Introductionmentioning

confidence: 99%

Can training over phone calls help improve outcomes for COVID-19 positive patients under home isolation? An analysis of the COVID-19 Care Companion Program in Punjab, India

Murthy¹,

Chandrasekar²,

Yan³

et al. 2023

Clinical Epidemiology and Global Health

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Impact of family-centred postnatal training on maternal and neonatal health and care practices in district hospitals in two states in India: a pre–post study

Cited by 7 publications

References 11 publications

Qualitative assessment of family caregiver-centered neonatal education program in Karnataka, India

Qualitative assessment of family caregiver-centered neonatal education program in Karnataka, India

Improving newborn health with family-centered, early postnatal care: a quasi-experimental study

Can training over phone calls help improve outcomes for COVID-19 positive patients under home isolation? An analysis of the COVID-19 Care Companion Program in Punjab, India

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