Effect of timing of first postnatal care home visit on neonatal mortality in Bangladesh: a observational cohort study

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Abstract
Objective To assess the effect of the timing of first postnatal home visit by community health workers on neonatal mortality. Design Analysis of prospectively collected data using time varying discrete hazard models to estimate hazard ratios for neonatal mortality according to day of first postnatal home visit. Data source Data from a community based trial of neonatal care interventions conducted in Bangladesh during 2004-5. Main outcome measure Neonatal mortality. Results 9211 live births were included. Among infants who survived the first day of life, neonatal mortality was 67% lower in those who received a visit on day one than in those who received no visit (adjusted hazard ratio 0.33, 95% confidence interval 0.23 to 0.46; PConclusions In developing countries, especially where home delivery with unskilled attendants is common, postnatal home visits within the first two days of life by trained community health workers can significantly reduce neonatal mortality.