| dc.description.abstract | Background: Despite considerable progress in reduction of both under-five and maternal mortality in recent
decades, Bangladesh is still one of the low and middle income countries with high burden of maternal and
neonatal mortality. The primary objective of the current study is to measure the impact of a comprehensive
package of interventions on maternal and neonatal mortality. In addition, changes in coverage, quality and
utilization of maternal and newborn health (MNH) services, social capital, and cost effectiveness of the interventions
will be measured.
Methods: A community-based, cluster randomized controlled trial design will be adopted and implemented in 30
unions of three sub-districts of Chandpur district of Bangladesh. Every union, the lowest administrative unit of the
local government with population of around 20,000–30,000, will be considered a cluster. Based on the baseline
estimates, 15 clusters will be paired for random assignment as intervention and comparison clusters.
The primary outcome measure is neonatal mortality, and secondary outcomes are coverage of key interventions
like ANC, PNC, facility and skilled provider delivery. Baseline, midterm and endline household survey will be
conducted to assess the key coverage of interventions. Health facility assessment surveys will be conducted
periodically to assess facility readiness and utilization of MNH services in the participating health facilities.
Discussion: The current study is expected to provide essential strong evidences on the impact of a comprehensive
package of interventions to the Bangladesh government, and other developmental partners. The study results may
help in prioritizing, planning, and scaling-up of Safe Motherhood Promotional interventions in other geographical
areas of Bangladesh as well as to inform other developing countries of similar settings. | en_US |
