Clinical Trials Logo

Clinical Trial Summary

The Umeed-e-Nau (UeN) initiative aims to support the introduction, scale up, and further piloting of high quality and high impact interventions to improve Maternal, Newborn And Child Health (MNCH)in Pakistan by harnessing the potential of both public and private sectors, coupled with introduction of women and girls empowerment interventions. UeN has two major components: 1) Introducing proven effective MNCH interventions at scale in 8 rural districts of Pakistan, and 2) Generating evidence on innovative approaches to improve MNCH while included in public health programs in Pakistan. There are six trials that are being conducted to address different evidences gaps to improve maternal, newborn and child health in Pakistan. The protocols of the trials will be registered separately.


Clinical Trial Description

Pakistan's continued high maternal, neonatal, and child mortality is affecting the overall development and national growth. The estimated national maternal mortality ratio ranges from 250 - 750 per 100,000 live births per year, while neonatal mortality rate ranges from 43 - 66 per 1,000 live births per year across the provinces of Pakistan. The under-five mortality rate is 89 per 1,000 live births per year, and diarrhea and pneumonia are two of the most common causes of post-neonatal mortality. Together, they account for more than 30% of all under five deaths in Pakistan. Majority of maternal, newborn and child deaths are preventable and treatable given programs are designed and delivered through an efficient public health system that takes into account the geographic and social structures. There are several factors resulting in slow progress and improvement of MNCH indicators. These include poor coverage, delayed scale up of effective interventions within the existing health system platforms, lack of women's and girls' empowerment, voice, and participation, and lack of community awareness and support regarding health conditions and poverty. Many of the risk factors that impact maternal and newborn health, such as nutritional deficiencies, exist from adolescence, and becoming pregnant during this sensitive life stage has been found to slow and stunt one's growth In order to evaluate the impact of the UeN initiative quasi experimental study design will be used. The intervention groups are broadly divided into two groups. Both groups will serve as control against each other due to nature of targeting of age group by each intervention group type. Group one included maternal and newborn health districts. These districts are further divided into three sub groups. Sub group 1 will receive only interventions focusing on maternal health (1 district (Sangher)); sub group 2 will receive interventions focusing only on newborn health (1 district (Nasirabad)); sub group 3 will receive combined maternal and newborn interventions (two districts (Lasbila and Badin). Group two will receive child health interventions focusing on the implementation of the global action plan for pneumonia and diarrhea (GAPPD [4districts, Qamabar Shahdadkot Muzaffargarh, Rahim Yar Khan Jafferabad). This design will help us to evaluate independent and combined effect of maternal, newborn, and child health interventions to address maternal, newborn and child health outcomes. We hypothesize that the roll out of proven and effective interventions within existing health delivery platforms for maternal, newborn, child and adolescent health will lead to significant reduction in perinatal mortality rate (20% compared to baseline) and at least 30% reduction in diarrhea and pneumonia case fatality rate in the target project districts. UeN design justification: The conceptual framework for UeN postulates that increased engagement with communities, empowering women and girls, including addressing access barriers; 2) strengthening capacity of the public and private health sectors mainly through revision of curricula based on new evidence, developing management protocols for different cadre of health workers and providers on MNCH and training; private Sector engagement; 3) provision of sustained supplies and 4) District Health Information System (DHIS) data use for decision making will lead to greater responsiveness of public and private service providers to women's and girls' needs - particularly those of undeserved women, girls and children. The UeN initiative aims to create opportunities in governance processes through revival and participation in District Health Management team (DHMTs), service delivery and citizens' voice and empowerment to transform public and private health sector interactions to drive improvements in MNCH and survival ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04184544
Study type Interventional
Source Aga Khan University
Contact
Status Active, not recruiting
Phase N/A
Start date March 1, 2017
Completion date June 30, 2023

See also
  Status Clinical Trial Phase
Not yet recruiting NCT04070066 - Educational Strategy IN Exchange Transfusion N/A
Recruiting NCT04405700 - Measuring Adverse Pregnancy and Newborn Congenital Outcomes
Completed NCT04258722 - Reducing Adverse Delivery Outcomes Through Teleneonatology: A Feasibility Study N/A
Recruiting NCT05728307 - Post-market Observation of a Wireless Vital Sign Monitor for Hospitalized Newborns in Kenya
Completed NCT01346813 - Epidemiology of Painful Procedures in Neonates N/A
Active, not recruiting NCT04054453 - Prevention of Epilepsy by Reducing Neonatal Encephalopathy N/A
Recruiting NCT06256406 - Effects of Confortable Environment, Kangaroo Care and Music Therapy in Newborns in Neonatal Intensive Care Unit N/A
Completed NCT04925908 - Exclusive Breastfeeding in Infants of Mothers Infected With Novel Coronavirus
Recruiting NCT03235635 - Metagenomic Analysis of Gut Microbiome in Preterm N/A
Completed NCT04323397 - Nasal HFOV Versus Nasal SIPPV in Neonate Following Extubation: RCT Crossover Study N/A
Completed NCT04422041 - Comparison of Early Versus Very Early Postnatal Discharge on Hospital Readmissions in Newborns N/A
Completed NCT02643472 - GPS (Giving Parents Support): Parent Navigation After NICU Discharge N/A
Recruiting NCT06081075 - Newborn Genomics Programme
Recruiting NCT05639309 - Liver Regional Oxygen Saturation in Preterm Patent Ductus Arteriosus
Completed NCT03350022 - Sham Feeding Post-operative Infants N/A
Recruiting NCT06170892 - Kangaroo Position in Preterm Newborn Infants Under Oxygen Therapy N/A
Completed NCT06130488 - Implementation at Scale and Evaluation of KMC N/A
Not yet recruiting NCT03786497 - Protecting Brains and Saving Futures - the PBSF Protocol
Completed NCT04191239 - Comparing Two Different Modes of Ventilation in Pretem Neonates Bilevel VG and PRVC
Completed NCT04734002 - Neonatal Surgery Intensive Care Unit: Hacettepe Experience