Compliance to iNCK components in the intervention group and self-reported clean delivery, cord care and emollient practices in the standard of care group stratified by place of delivery
| Intervention | Control | ||||||
| Intervention | Utilisation | Total n=2233 | Facility delivery n=1351 | Home delivery n=882 | Total n=2338 | Facility delivery n=1440 | Home delivery n=898 |
| Clean birth kit | Used at time of delivery | 2049 (91.7) | 1213 (89.8) | 836 (94.6) | 1177 (50.3) | 1019 (70.8) | 158 (17.6) |
| Early initiation of breast feeding | Baby latched within 1 hour of delivery | 387 (17.3) | 176 (13.0) | 211 (23.9) | 372 (15.9) | 166 (11.5) | 206 (22.9) |
| Cord care | |||||||
| Any application of chlorhexidine | Used during neonatal period | 2209 (98.9) | 1330 (98.4) | 879 (99.7) | --- | --- | --- |
| First application on day 1* | 704 (31.9) | 350 (26.3) | 354 (40.3) | --- | --- | --- | |
| First application on day 2* | 725 (32.8) | 416 (31.3) | 309 (35.2) | --- | --- | --- | |
| First application on day 3* | 723 (32.7) | 519 (39.0) | 204 (23.2) | --- | --- | --- | |
| First application later than day 3* | 57 (2.6) | 45 (3.4) | 12 (1.4) | --- | --- | --- | |
| Exclusive application of chlorhexidine | Used during neonatal period† | 1621 (90.5) | 989 (90.8) | 632 (90.0) | --- | --- | --- |
| First application on day 1‡ | 484 (29.9) | 241 (24.4) | 243 (38.4) | --- | --- | --- | |
| First application on day 2‡ | 548 (33.8) | 315 (31.9) | 233 (36.9) | --- | --- | --- | |
| First application on day 3‡ | 561 (34.6) | 409 (41.4) | 152 (24.1) | --- | --- | --- | |
| First application later than day 3‡ | 28 (1.7) | 24 (2.4) | 4 (0.6) | --- | --- | --- | |
| Application of chlorhexidine and other substance | Used during neonatal period† | 170 (9.5) | 100 (9.2) | 70 (10.0) | --- | --- | --- |
| Surma§ | 82 (48.2) | 35 (35.0) | 47 (67.1) | --- | --- | --- | |
| Dettol§ | 65 (38.2) | 53 (53.0) | 12 (17.1) | --- | --- | --- | |
| Oil§ | 33 (19.4) | 19 (19.0) | 14 (20.0) | --- | --- | --- | |
| Turmeric§ | 10 (5.9) | 7 (7.0) | 3 (4.3) | --- | --- | --- | |
| Other§ | 9 (5.3) | 5 (5.0) | 4 (5.7) | --- | --- | --- | |
| Other substance only | Used during neonatal period¶ | 6 (37.5) | 5 (33.3) | 1 (100.0) | 2285 (97.7) | 1400 (97.2) | 885 (98.6) |
| Dettol** | 4 (66.7) | 4 (80.0) | --- | 1388 (60.7) | 1018 (72.7) | 370 (41.8) | |
| Surma** | 2 (33.3) | 1 (20.0) | 1 (100.0) | 1174 (51.4) | 584 (41.7) | 590 (66.7) | |
| Ghee** | --- | --- | --- | 228 (10.0) | 113 (12.8) | 115 (8.2) | |
| Oil** | 2 (33.3) | 1 (20.0) | 1 (100.0) | 851 (37.2) | 475 (33.9) | 376 (42.5) | |
| Turmeric** | --- | --- | --- | 80 (3.5) | 39 (2.8) | 41 (4.6) | |
| Other** | --- | --- | --- | 93 (4.0) | 55 (3.8) | 38 (4.2) | |
| Emollient usage | |||||||
| Sunflower oil emollient | Used during neonatal period | 2209 (98.9) | 1331 (98.5) | 878 (99.5) | 2 (0.1) | 2 (0.1) | --- |
| First application before day 3†† | 58 (2.6) | 28 (2.1) | 30 (3.4) | --- | --- | --- | |
| First application on day 3†† | 2079 (94.1) | 1243 (93.4) | 836 (95.2) | --- | --- | --- | |
| First application later than day 3†† | 72 (3.3) | 60 (4.5) | 12 (1.4) | --- | --- | --- | |
| Other emollient used | Used during neonatal period‡‡ | 42 (30.9) | 30 (26.3) | 12 (54.5) | 2315 (99.0) | 1419 (98.5) | 896 (99.8) |
| Mustard§§ | 36 (85.7) | 25 (83.3) | 11 (91.7) | 2291 (99.0) | 1402 (98.8) | 889 (99.2) | |
| Ghee§§ | 3 (7.1) | 2 (6.7) | 1 (8.3) | 197 (8.5) | 119 (8.4) | 78 (8.7) | |
| Lotion§§ | 5 (11.9) | 5 (16.7) | --- | 157 (6.8) | 121 (8.5) | 36 (4.0) | |
| Other§§ | --- | --- | --- | 67 (2.9) | 49 (3.4) | 18 (2.0) | |
| Intervention | Control | ||||||
| Intervention | Utilisation | Total n=2233 | Facility delivery n=1351 | Home delivery n=882 | Total | Facility delivery | Home delivery |
| Thermal care | |||||||
| TS | Used during neonatal period | 2204 (98.7) | 1329 (98.4) | 875 (99.2) | --- | --- | --- |
| First application on day 1¶¶ | 624 (28.3) | 298 (22.4) | 326 (37.3) | --- | --- | --- | |
| First application on day 2¶¶ | 686 (31.1) | 381 (28.7) | 305 (34.9) | --- | --- | --- | |
| First application on day 3¶¶ | 828 (37.6) | 591 (44.5) | 237 (27.1) | --- | --- | --- | |
| First application later than day 3¶¶ | 66 (3.0) | 59 (4.4) | 7 (0.8) | --- | --- | --- | |
| ThermoAction (ie, heat pack, reflective blanket, seeking healthcare) | Number of time TS turned blue (fever)*** | 182 | 114 | 68 | --- | --- | --- |
| Healthcare Sought††† | 152 (83.5) | 94 (82.5) | 58 (85.3) | --- | --- | --- | |
| Number of times TS turned pale green (cold stress)*** | 15 | 8 | 7 | --- | --- | --- | |
| Skin-to-skin care initiated‡‡‡ | 15 (100.0) | 8 (100.0) | 7 (100.0) | --- | --- | --- | |
| Number of times TS turned red (moderate hypothermia)*** | 11 | 6 | 5 | --- | --- | --- | |
| All three: blanket, heat pack and healthcare§§§ | 5 (45.5) | 3 (27.3) | 2 (18.2) | --- | --- | --- | |
| Any two of: blanket, heat pack or healthcare§§§ | 4 (36.4) | 4 (36.4) | 4 (36.4) | --- | --- | --- | |
| Any one of: blanket, heat pack or healthcare§§§ | 1 (9.1) | 1 (9.1) | 0 (0.0) | --- | --- | --- | |
| None: blanket, heater or healthcare§§§ | 1 (9.1) | 1 (9.1) | 0 (0.0) | --- | --- | --- | |
| Number of times TS turned black (severe hypothermia) | 11 | 8 | 3 | --- | --- | --- | |
| All three: blanket, heat pack and healthcare¶¶¶ | 6 (54.5) | 4 (36.4) | 2 (18.2) | --- | --- | --- | |
| Any two of: blanket, heat pack or health care¶¶¶ | 1 (9.1) | 1 (9.1) | 1 (9.1) | --- | --- | --- | |
| Any one of: blanket, heat pack or healthcare¶¶¶ | 1 (9.1) | 1 (9.1) | 1 (9.1) | --- | --- | --- | |
| None: blanket, heat pack or healthcare¶¶¶ | 3 (27.3) | 3 (27.3) | 0 (0.0) | --- | --- | --- | |
*n=2209 in the total group, n=1330 in the facility delivery group, n=879 in the home delivery group. Denominators reflect the number of participants who used chlorhexidine.
†n=1791 in the total group, n=1089 in the facility delivery group, n=702 in the home delivery group. Denominators reflect the number of participants who used chlorhexidine and responded to queries regarding the use of other substance to the umbilical cord.
‡n=1621 in the total group, n=989 in the facility delivery group, n=632 in the home delivery group. Denominators reflect the number of participants who reported to have used chlorhexidine exclusively.
§n=170 in the total group, n=100 in the facility delivery group, n=70 in the home delivery group. Denominators reflect the number of participants who reported to have used chlorhexidine and applied other substance to the umbilical cord. When asked about the application of ‘other’ substances to the umbilical cord, participants could respond with more than one answer.
¶n=16 in the total group, n=15 in the facility delivery group, n=1 in the home delivery group. n=2338 in the control total group, n=1440 in the control facility delivery group, n=898 in the control home delivery group. Denominators reflect the number of participants who reported to have only applied a substance other than chlorhexidine to the umbilical cord.
**n=6 in the intervention total group, n=5 in the intervention facility delivery group, n=1 in the intervention home delivery group. n=2285 in the control total group, n=1400 in the control facility delivery group, n=885 in the control home delivery group. Denominators reflect the number of participants who reported to have only applied a substance other than chlorhexidine to the umbilical cord. When asked about the application of ‘other’ substances to the umbilical cord, participants could respond with more than one answer.
††n=2209 in the total group, n=1331 in the facility delivery group, n=878 in the home delivery group. Denominators reflect the number of participants who used sunflower oil emollient.
‡‡n=136 in the intervention total group, n=114 in the intervention facility delivery group, n=22 in the intervention home delivery group. n=2338 in the control total group, n=1440 in the control facility delivery group, n=898 in the control home delivery group. Denominators reflect the number of participants who used and responded to queries regarding the use of emollients other than sunflower oil.
§§n=42 in the intervention total group, n=30 in the intervention facility delivery group, n=12 in the intervention home delivery group. n=2315 in the control total group, n=1419 in the control facility delivery group, n=896 in the control home delivery group. Denominators reflect the number of participants who reported to have used an oil other than sunflower oil. When asked about the application of ‘other’ oil usage, participants could respond with more than one answer. Data were not available to distinguish between any oil application and exclusive oil application in the intervention group and only 136 participants in the kit group who used sunflower oil to massage their newborns were asked if they also used other oils for massage.
¶¶n=2204 in the intervention total group, n=1329 in the intervention facility delivery group, n=875 in the intervention home delivery group. Denominators reflect the number of participants who reported to have used TS.
***Fever was defined via TS as a temperature of ≥39.0°C; Cold stress was defined via TS as a temperature between 36.0°C and 36.4°C; moderate and severe hypothermia were defined via TS as temperatures between ≥35.5 and<36.0°C and <35.5°C, respectively.
†††n=182 in total group, n=114 in facility delivery group, n=68 in home delivery group. Denominators reflect the number of participants who reported that TS turned blue (indicated fever).
‡‡‡n=15 in the intervention total group, n=8 in the intervention facility delivery group, n=7 in the intervention home delivery group. Denominators reflect the number of participants who reported that TS turned light green (cold stress).
§§§n=11 in the intervention total group, n=6 in the intervention facility delivery group, n=5 in the intervention home delivery group. Denominators reflect the number of participants who reported that TS turned red (moderate hypothermia).
¶¶¶n=11 in the intervention total group, n=8 in the intervention facility delivery group, n=3 in the intervention home delivery group. Denominators reflect the number of participants who reported that TS turned block (severe hypothermia).
TS, ThermoSpot; iNCK, integrated neonatal care kit.