Trends in use of referral hospital services for care of sick newborns in a community-based intervention in Tangail District, Bangladesh

Abstract

The Projahnmo-II Project in Mirzapur upazila (sub-district), Tangail district, Bangladesh, is promoting care-seeking for sick newborns through health education of families, identification and referral of sick newborns in the community by community health workers (CHWs), and strengthening of neonatal care in Kumudini Hospital, Mirzapur. Data were drawn from records maintained by the CHWs, referral hospital registers, a baseline household survey of recently-delivered women conducted from March to June 2003, and two interim household surveys in January and September 2005. Increases were observed in self-referral of sick newborns for care, compliance after referral by the CHWs, and care-seeking from qualified providers and from the Kumudini Hospital, and decreases were observed in care-seeking from unqualified providers in the intervention arm. An active surveillance for illness by the CHWs in the home, education of families by them on recognition of danger signs and counselling to seek immediate care for serious illness, and improved linkages between the community and the hospital can produce substantial increases in care-seeking for sick newborns.

Fig. 1.

Intervention model: promotion by community health workers of care for sick newborns at Kumudini Hospital between April 2004 and September 2005 (Table 1)

Fig. 2.

Trend in proportion of sick newborns for whom care was sought from qualified providers

Fig. 3.

Trend in proportion of sick newborns for whom care was sought from Kumudini Hospital

Fig. 4.

Trend in proportion of sick newborns for whom care was sought from unqualified providers