TY - JOUR
T1 - Engagement of the community, traditional leaders, and public health system in the design and implementation of a large community-based, cluster-randomized trial of umbilical cord care in Zambia
AU - Hamer, Davidson H.
AU - Herlihy, Julie
AU - Musokotwane, Kebby
AU - Banda, Bowen
AU - Mpamba, Chipo
AU - Mwangelwa, Boyd
AU - Pilingana, Portipher
AU - Thea, Donald M.
AU - Simon, Jonathon L.
AU - Yeboah-Antwi, Kojo
AU - Grogan, Caroline
AU - Semrau, Katherine E.A.
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Conducting research in areas with diverse cultures requires attention to community sensitization and involvement. The process of community engagement is described for a large community-based, cluster-randomized, controlled trial comparing daily 4%chlorhexidine umbilical cord wash to dry cord care for neonatal mortality prevention in Southern Province, Zambia. Study preparations required baseline formative ethnographic research, substantial community sensitization, and engagement with three levels of stakeholders, each necessitating different strategies. Cluster-specific birth notification systems developed with traditional leadership and community members using community-selected data collectors resulted in a post-natal home visit within 48 hours of birth in 96% of births. Of 39,679 pregnant women enrolled (93% of the target of 42,570), only 3.7%were lost to follow-up or withdrew antenatally; 0.2%live-born neonates were lost by day 28 of follow-up. Conducting this trial in close collaboration with traditional, administrative, political, and community stakeholders facilitated excellent study participation, despite structural and sociocultural challenges.
AB - Conducting research in areas with diverse cultures requires attention to community sensitization and involvement. The process of community engagement is described for a large community-based, cluster-randomized, controlled trial comparing daily 4%chlorhexidine umbilical cord wash to dry cord care for neonatal mortality prevention in Southern Province, Zambia. Study preparations required baseline formative ethnographic research, substantial community sensitization, and engagement with three levels of stakeholders, each necessitating different strategies. Cluster-specific birth notification systems developed with traditional leadership and community members using community-selected data collectors resulted in a post-natal home visit within 48 hours of birth in 96% of births. Of 39,679 pregnant women enrolled (93% of the target of 42,570), only 3.7%were lost to follow-up or withdrew antenatally; 0.2%live-born neonates were lost by day 28 of follow-up. Conducting this trial in close collaboration with traditional, administrative, political, and community stakeholders facilitated excellent study participation, despite structural and sociocultural challenges.
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U2 - 10.4269/ajtmh.14-0218
DO - 10.4269/ajtmh.14-0218
M3 - Review article
C2 - 25646254
AN - SCOPUS:84924280757
VL - 92
SP - 666
EP - 672
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
SN - 0002-9637
IS - 3
ER -