Vollständiger Abstract
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Abstract Around three million babies are stillborn or die shortly after birth each year worldwide, underscoring a persistent and unacceptable burden on families and health systems. To help address this challenge, we developed the facility-based, multi-faceted Action Leveraging Evidence to reduce perinatal Mortality and Morbidity (ALERT) intervention. ALERT promoted essential practices of intrapartum childbirth using (i) co-design, (ii) training, (iii) quality improvement and (iv) leadership mentoring. We evaluated ALERT using a stepped-wedge cluster-randomized trial with five 6-month periods across 16 hospitals in Benin, Malawi, Tanzania and Uganda. Among 134,630 women (including 139,300 neonates), the intervention was associated with 22% lower odds of the composite co-primary outcome, early perinatal mortality, defined as fresh stillbirth and 24 h neonatal mortality (adjusted odds ratio 0.78, 95% confidence interval 0.65–0.94), but not with the co-primary outcome, fresh stillbirth (adjusted odds ratio 0.88, 95% confidence interval 0.68–1.13). Despite the limitation of only including 16 hospitals, the diversity of settings across four sub-Saharan African countries supports the finding that early perinatal mortality and morbidity could be reduced through implementation of multi-faceted, context-specific strategies to build maternity provider capacities. Pan African Clinical Trial Registry: 202006793783148 .
Bibliografischer Nachweis
Publikationsdaten
- Autor:innen
- Claudia Hanson, Joseph Akuze, Kristi Sidney Annerstedt, Helle Mölsted Alvesson, Sunjuri Sun, Manuela Straneo, Nicola Orsini, Lenka Benova, Mechthild M. Gross, Bruno Marchal, Rian Snijders, Effie Chipeta, Peter Waiswa, Hussein Kidanto, Jean-Paul Dossou, Andrea Barnabas Pembe, Regine Unkels, Soha El Halabi, Ann-Beth Nygaard Moller, Veronika Tirado, Anastasia Månsson, Maria del Rosario Alsina, Sibylle Herzig van Wees, Elizabeth O. Ayebare, Gorrette Nalwadda, Josephine Babirye, Philip Wanduru, Gertrude Namazzi, Virginia Castellano Pleguezuelo, Therese Delvaux, Jil Molenaar, Joanne Welsh, Bianca Kandeya, Samuel Meja, William Stones, Yesaya Z. Nyirenda, Hussein L. Kidanto
- Quelle
- Nature Medicine
- Publikation
- 2026-01-01
- Band / Ausgabe
- Nicht angegeben
- Seiten
- Nicht angegeben
- ISSN / ISBN
- 1078-8956, 1546-170X
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Zitierfähiger Nachweis
Claudia Hanson, Joseph Akuze, Kristi Sidney Annerstedt, Helle Mölsted Alvesson, Sunjuri Sun, Manuela Straneo, Nicola Orsini, Lenka Benova, Mechthild M. Gross, Bruno Marchal, Rian Snijders, Effie Chipeta, Peter Waiswa, Hussein Kidanto, Jean-Paul Dossou, Andrea Barnabas Pembe, Regine Unkels, Soha El Halabi, Ann-Beth Nygaard Moller, Veronika Tirado, Anastasia Månsson, Maria del Rosario Alsina, Sibylle Herzig van Wees, Elizabeth O. Ayebare, Gorrette Nalwadda, Josephine Babirye, Philip Wanduru, Gertrude Namazzi, Virginia Castellano Pleguezuelo, Therese Delvaux, Jil Molenaar, Joanne Welsh, Bianca Kandeya, Samuel Meja, William Stones, Yesaya Z. Nyirenda, Hussein L. Kidanto (2026). A multi-faceted hospital-based intervention for intrapartum care in sub-Saharan Africa: a stepped-wedge cluster-randomized trial. Nature Medicine. https://doi.org/10.1038/s41591-026-04599-w
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