Nisha Rana - Academia.edu (original) (raw)

Papers by Nisha Rana

Research paper thumbnail of Additional file 2 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 2 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 2. Focus group discussion guide on EN BIRTH data collection.

Research paper thumbnail of Chlorhexidine for facility-based umbilical cord care: EN-BIRTH multi-country validation study

BMC Pregnancy and Childbirth, 2021

Background Umbilical cord hygiene prevents sepsis, a leading cause of neonatal mortality. The Wor... more Background Umbilical cord hygiene prevents sepsis, a leading cause of neonatal mortality. The World Health Organization recommends 7.1% chlorhexidine digluconate (CHX) application to the umbilicus after home birth in high mortality contexts. In Bangladesh and Nepal, national policies recommend CHX use for all facility births. Population-based household surveys include optional questions on CHX use, but indicator validation studies are lacking. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) was an observational study assessing measurement validity for maternal and newborn indicators. This paper reports results regarding CHX. Methods The EN-BIRTH study (July 2017–July 2018) included three public hospitals in Bangladesh and Nepal where CHX cord application is routine. Clinical-observers collected tablet-based, time-stamped data regarding cord care during admission to labour and delivery wards as the gold standard to assess accuracy of women’s report at exi...

Research paper thumbnail of Additional file 8 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 8 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 8. Android tablet readiness assessment, EN-BIRTH study.

Research paper thumbnail of Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Acta Paediatrica, 2019

Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of ... more Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of hyperbilirubinemia in term newborns.Method: Term normal vagainal deliveries (n=540) were randomized ...

Research paper thumbnail of Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income Country

Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income Country

European Journal of Pediatrics, 2016

Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income... more Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income Country

Research paper thumbnail of Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia on the day of birth or jaundice in the first 4 weeks

Acta Paediatrica, Jul 15, 2019

Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinae... more Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinaemia. Methods We recruited 540 normal vaginal deliveries at the Paropakar Maternity and Women's Hospital in Kathmandu, Nepal, from 2 October to 21 November 2014. They were randomised into two groups: 257/270 were cord clamped within 60 seconds and 209/270 after 180 seconds. Transcutaneous bilirubin was measured at discharge and 24 hours. At four weeks, 506 mothers were successfully contacted by phone and the health status of the baby and their history of jaundice and treatment was recorded. Results Based on transcutaneous bilirubin at discharge, 22/261 (8.4%) in the early group and 25/263 (9.5%) in the delayed group (p=0.76) were at high risk of subsequent hyperbilirubinemia. At the four-week follow up, jaundice was reported in 13/253 (5.1%) in the early and 17/253 (6.7%) in the delayed group (p=0.57) and 3/253 (1.2 %) of the early and 1/253 (0.4%) of the delayed group (p= 0.62) received treatment. All analyses were based on intention-to-treat. Conclusion Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia during the first day of life or risk of jaundice within four weeks compared with the early group.

Research paper thumbnail of Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia on the day of birth or jaundice in the first 4 weeks

Acta Paediatrica, 2019

Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinae... more Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinaemia. Methods We recruited 540 normal vaginal deliveries at the Paropakar Maternity and Women's Hospital in Kathmandu, Nepal, from 2 October to 21 November 2014. They were randomised into two groups: 257/270 were cord clamped within 60 seconds and 209/270 after 180 seconds. Transcutaneous bilirubin was measured at discharge and 24 hours. At four weeks, 506 mothers were successfully contacted by phone and the health status of the baby and their history of jaundice and treatment was recorded. Results Based on transcutaneous bilirubin at discharge, 22/261 (8.4%) in the early group and 25/263 (9.5%) in the delayed group (p=0.76) were at high risk of subsequent hyperbilirubinemia. At the four-week follow up, jaundice was reported in 13/253 (5.1%) in the early and 17/253 (6.7%) in the delayed group (p=0.57) and 3/253 (1.2 %) of the early and 1/253 (0.4%) of the delayed group (p= 0.62) received treatment. All analyses were based on intention-to-treat. Conclusion Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia during the first day of life or risk of jaundice within four weeks compared with the early group.

Research paper thumbnail of Effect of Delayed Cord Clamping of Term Babies on Neurodevelopment at 12 Months: A Randomized Controlled Trial

Background: Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a... more Background: Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction of anemia at 12 months, and an improved development at 4 years. Assessment of the development after DCC has not been performed earlier in a setting with a high prevalence of iron deficiency. Objective: The aim of this paper was to investigate the effects of DCC compared to early cord clamping (ECC) on the development evaluated with the Ages and Stages Questionnaire (ASQ) at 12 months of age. Method: We conducted a randomized controlled trial investigating the effect of DCC (≥180 s) versus ECC (≤60 s) in 540 full-term deliveries. Twelve months after delivery, the parents reported their infant's development by ASQ. Infants having a score < 1 standard deviation (SD) under the mean score were considered "at risk" of affected neurodevelopment. Results: At 12 months of age, 332 (61.5%) infants were assessed. Fewer children in the DCC group were "at risk" of having affected neurodevelop-ment measured by the ASQ total score, 21 (7.8%) versus 49 (18.1%) in the ECC group. The relative risk was 0.43 (0.26-0.71). Infants in the DCC group had higher mean total scores (SD), 290.4 (10.4) versus 287.2 (10.1), p = 0.01. Significantly fewer infants in the delayed group were "at risk" and had higher scores in the domains "communication", "gross mo-tor", and "personal-social". Conclusions: DCC after 3 min was associated with an improvement of the overall neurodevel-opment assessed at 12 months of age as compared to infants in the group with cord clamping within 1 min.

Research paper thumbnail of MOESM1 of Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal

MOESM1 of Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal

Additional file 1. Definitions of variables. Definitions of variables (relevant to this study) co... more Additional file 1. Definitions of variables. Definitions of variables (relevant to this study) contained in the structured checklist, and their method of data collection.

Research paper thumbnail of Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Acta Paediatrica, 2019

Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of ... more Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of hyperbilirubinemia in term newborns.Method: Term normal vagainal deliveries (n=540) were randomized ...

Research paper thumbnail of Effect of Delayed Cord Clamping of Term Babies on Neurodevelopment at 12 Months: A Randomized Controlled Trial

Effect of Delayed Cord Clamping of Term Babies on Neurodevelopment at 12 Months: A Randomized Controlled Trial

Neonatology, Jan 2, 2018

Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction o... more Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction of anemia at 12 months, and an improved development at 4 years. Assessment of the development after DCC has not been performed earlier in a setting with a high prevalence of iron deficiency. The aim of this paper was to investigate the effects of DCC compared to early cord clamping (ECC) on the development evaluated with the Ages and Stages Questionnaire (ASQ) at 12 months of age. We conducted a randomized controlled trial investigating the effect of DCC (≥180 s) versus ECC (≤60 s) in 540 full-term deliveries. Twelve months after delivery, the parents reported their infant's development by ASQ. Infants having a score < 1 standard deviation (SD) under the mean score were considered "at risk" of affected neurodevelopment. At 12 months of age, 332 (61.5%) infants were assessed. Fewer children in the DCC group were "at risk" of having affected neurodevelopment measu...

Research paper thumbnail of Delayed cord clamping in Nepal-Evidence for implementation

Rana, N. 2019. Delayed cord clamping in Nepal-Evidence for implementation. Digital Comprehensive ... more Rana, N. 2019. Delayed cord clamping in Nepal-Evidence for implementation. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1557. 66 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0611-7. The aims of this thesis were to investigate effects of timing of umbilical cord clamping on newborn health, and on infant outcomes up to 12 months of age in a high-risk population and to explore the context of implementing changed umbilical cord clamping practices in Nepal. A randomised controlled trial with 540 late preterm and term infants born by normal vaginal delivery was set up at a maternity hospital in Kathmandu, Nepal. Infants were enrolled in two parallel groups (1:1 ratio), randomised to early (ECC) (≤60 seconds) or delayed cord clamping (DCC) (≥180 seconds). To get a deeper understanding of barriers and enablers for change in clinical practise in relation to cord clamping, a qualitative study with delivery staff was set up. Focus group ...

Research paper thumbnail of Additional file 7 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 7 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 7. Key features of the EN-BIRTH data capture application.

Research paper thumbnail of Additional file 6 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 6 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 6. List of electronic tools reported by organisations with at least two responden... more Additional file 6. List of electronic tools reported by organisations with at least two respondents to the survey. Table shows number of stakeholder survey respondents per organisation (where at least 2 respondents from the same organisation responded) and the data collection, management and analysis tools used per organisation.

Research paper thumbnail of Additional file 4 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 4 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 4. List of studies excluded from the systematic review (2010–2020) and their reas... more Additional file 4. List of studies excluded from the systematic review (2010–2020) and their reasons for exclusion. Dataset that describes the studies excluded from the systematic review (2010–2020) and includes the first author, title, journal and year of publication of the study and the reason for exclusion.

Research paper thumbnail of Every Newborn Birth Indicator Research Tracking in Hospitals (EN-BIRTH) - Supplementary Materials

Every Newborn Birth Indicator Research Tracking in Hospitals (EN-BIRTH) - Supplementary Materials

The EN-BIRTH study aims to validate selected newborn and maternal indicators for routine facility... more The EN-BIRTH study aims to validate selected newborn and maternal indicators for routine facility-based tracking of coverage and quality of care for use at district, national and global levels. This is an observational study of >22,000 facility births in three countries (Tanzania, Bangladesh and Nepal). Direct clinical observation are compared with facility register data and a pre-discharge maternal recall survey for indicators including: uterotonic administration, essential newborn care, neonatal resuscitation and Kangaroo Mother Care. Indicators for neonatal infection management and antenatal corticosteroid administration, will be validated using inpatient records because they cannot be easily observed. Trained clinical observers in labour/delivery ward, operation theatre, and Kangaroo Mother Care ward/areas collect data using a tablet-based customised data capturing application. Sensitivity will be calculated for numerators of all indicators and specificity for those numerator...

Research paper thumbnail of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

BMC Pregnancy and Childbirth, 2021

BackgroundObservation of care at birth is challenging with multiple, rapid and potentially concur... more BackgroundObservation of care at birth is challenging with multiple, rapid and potentially concurrent events occurring for mother, newborn and placenta. Design of electronic data (E-data) collection needs to account for these challenges. TheEvery NewbornBirth Indicators Research Tracking in Hospitals (EN-BIRTH) was an observational study to assess measurement of indicators for priority maternal and newborn interventions and took place in five hospitals in Bangladesh, Nepal and Tanzania (July 2017–July 2018). E-data tools were required to capture individually-linked, timed observation of care, data extraction from hospital register-records or case-notes, and exit-survey data from women.MethodsTo evaluate this process for EN-BIRTH, we employed a framework organised around five steps for E-data design, data collection and implementation. Using this framework, a mixed methods evaluation synthesised evidence from study documentation, standard operating procedures, stakeholder meetings an...

Research paper thumbnail of Additional file 5 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 5 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 5. Data flow assessment checklist by EN-BIRTH intervention.

Research paper thumbnail of Additional file 3 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 3 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 3. Consolidated criteria for reporting qualitative research (COREQ) checklist.

Research paper thumbnail of Additional file 1: of Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) – a randomized clinical trial

Additional file 1: of Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) – a randomized clinical trial

ANOVA analysis including post-hoc multiple comparisons comparing the infants divided into three g... more ANOVA analysis including post-hoc multiple comparisons comparing the infants divided into three groups, intact cord resuscitation per protocol (CC ≥ 180 s), intact cord resuscitation protocol violaton (CC

Research paper thumbnail of Additional file 2 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 2 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 2. Focus group discussion guide on EN BIRTH data collection.

Research paper thumbnail of Chlorhexidine for facility-based umbilical cord care: EN-BIRTH multi-country validation study

BMC Pregnancy and Childbirth, 2021

Background Umbilical cord hygiene prevents sepsis, a leading cause of neonatal mortality. The Wor... more Background Umbilical cord hygiene prevents sepsis, a leading cause of neonatal mortality. The World Health Organization recommends 7.1% chlorhexidine digluconate (CHX) application to the umbilicus after home birth in high mortality contexts. In Bangladesh and Nepal, national policies recommend CHX use for all facility births. Population-based household surveys include optional questions on CHX use, but indicator validation studies are lacking. The Every Newborn Birth Indicators Research Tracking in Hospitals (EN-BIRTH) was an observational study assessing measurement validity for maternal and newborn indicators. This paper reports results regarding CHX. Methods The EN-BIRTH study (July 2017–July 2018) included three public hospitals in Bangladesh and Nepal where CHX cord application is routine. Clinical-observers collected tablet-based, time-stamped data regarding cord care during admission to labour and delivery wards as the gold standard to assess accuracy of women’s report at exi...

Research paper thumbnail of Additional file 8 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 8 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 8. Android tablet readiness assessment, EN-BIRTH study.

Research paper thumbnail of Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Acta Paediatrica, 2019

Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of ... more Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of hyperbilirubinemia in term newborns.Method: Term normal vagainal deliveries (n=540) were randomized ...

Research paper thumbnail of Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income Country

Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income Country

European Journal of Pediatrics, 2016

Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income... more Delayed Verses Early Cord Clamping : Anemia And Iron Deficiencyat 8 And 12 Months In A Low-Income Country

Research paper thumbnail of Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia on the day of birth or jaundice in the first 4 weeks

Acta Paediatrica, Jul 15, 2019

Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinae... more Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinaemia. Methods We recruited 540 normal vaginal deliveries at the Paropakar Maternity and Women's Hospital in Kathmandu, Nepal, from 2 October to 21 November 2014. They were randomised into two groups: 257/270 were cord clamped within 60 seconds and 209/270 after 180 seconds. Transcutaneous bilirubin was measured at discharge and 24 hours. At four weeks, 506 mothers were successfully contacted by phone and the health status of the baby and their history of jaundice and treatment was recorded. Results Based on transcutaneous bilirubin at discharge, 22/261 (8.4%) in the early group and 25/263 (9.5%) in the delayed group (p=0.76) were at high risk of subsequent hyperbilirubinemia. At the four-week follow up, jaundice was reported in 13/253 (5.1%) in the early and 17/253 (6.7%) in the delayed group (p=0.57) and 3/253 (1.2 %) of the early and 1/253 (0.4%) of the delayed group (p= 0.62) received treatment. All analyses were based on intention-to-treat. Conclusion Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia during the first day of life or risk of jaundice within four weeks compared with the early group.

Research paper thumbnail of Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia on the day of birth or jaundice in the first 4 weeks

Acta Paediatrica, 2019

Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinae... more Our aim was to investigate the effects of timing of cord clamping on the risk of hyperbilirubinaemia. Methods We recruited 540 normal vaginal deliveries at the Paropakar Maternity and Women's Hospital in Kathmandu, Nepal, from 2 October to 21 November 2014. They were randomised into two groups: 257/270 were cord clamped within 60 seconds and 209/270 after 180 seconds. Transcutaneous bilirubin was measured at discharge and 24 hours. At four weeks, 506 mothers were successfully contacted by phone and the health status of the baby and their history of jaundice and treatment was recorded. Results Based on transcutaneous bilirubin at discharge, 22/261 (8.4%) in the early group and 25/263 (9.5%) in the delayed group (p=0.76) were at high risk of subsequent hyperbilirubinemia. At the four-week follow up, jaundice was reported in 13/253 (5.1%) in the early and 17/253 (6.7%) in the delayed group (p=0.57) and 3/253 (1.2 %) of the early and 1/253 (0.4%) of the delayed group (p= 0.62) received treatment. All analyses were based on intention-to-treat. Conclusion Delayed cord clamping was not associated with an increased risk of hyperbilirubinaemia during the first day of life or risk of jaundice within four weeks compared with the early group.

Research paper thumbnail of Effect of Delayed Cord Clamping of Term Babies on Neurodevelopment at 12 Months: A Randomized Controlled Trial

Background: Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a... more Background: Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction of anemia at 12 months, and an improved development at 4 years. Assessment of the development after DCC has not been performed earlier in a setting with a high prevalence of iron deficiency. Objective: The aim of this paper was to investigate the effects of DCC compared to early cord clamping (ECC) on the development evaluated with the Ages and Stages Questionnaire (ASQ) at 12 months of age. Method: We conducted a randomized controlled trial investigating the effect of DCC (≥180 s) versus ECC (≤60 s) in 540 full-term deliveries. Twelve months after delivery, the parents reported their infant's development by ASQ. Infants having a score < 1 standard deviation (SD) under the mean score were considered "at risk" of affected neurodevelopment. Results: At 12 months of age, 332 (61.5%) infants were assessed. Fewer children in the DCC group were "at risk" of having affected neurodevelop-ment measured by the ASQ total score, 21 (7.8%) versus 49 (18.1%) in the ECC group. The relative risk was 0.43 (0.26-0.71). Infants in the DCC group had higher mean total scores (SD), 290.4 (10.4) versus 287.2 (10.1), p = 0.01. Significantly fewer infants in the delayed group were "at risk" and had higher scores in the domains "communication", "gross mo-tor", and "personal-social". Conclusions: DCC after 3 min was associated with an improvement of the overall neurodevel-opment assessed at 12 months of age as compared to infants in the group with cord clamping within 1 min.

Research paper thumbnail of MOESM1 of Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal

MOESM1 of Factors associated with timing of umbilical cord clamping in tertiary hospital of Nepal

Additional file 1. Definitions of variables. Definitions of variables (relevant to this study) co... more Additional file 1. Definitions of variables. Definitions of variables (relevant to this study) contained in the structured checklist, and their method of data collection.

Research paper thumbnail of Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Effect of delayed cord clamping on risk of hyperbilirubinemia in term newborns : A randomsed clinical trial in Nepal

Acta Paediatrica, 2019

Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of ... more Aim: The aim of this study is to investigate the effects of delayed cord clamping on the risk of hyperbilirubinemia in term newborns.Method: Term normal vagainal deliveries (n=540) were randomized ...

Research paper thumbnail of Effect of Delayed Cord Clamping of Term Babies on Neurodevelopment at 12 Months: A Randomized Controlled Trial

Effect of Delayed Cord Clamping of Term Babies on Neurodevelopment at 12 Months: A Randomized Controlled Trial

Neonatology, Jan 2, 2018

Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction o... more Delayed cord clamping (DCC) is associated with an improved iron status at 8 months, a reduction of anemia at 12 months, and an improved development at 4 years. Assessment of the development after DCC has not been performed earlier in a setting with a high prevalence of iron deficiency. The aim of this paper was to investigate the effects of DCC compared to early cord clamping (ECC) on the development evaluated with the Ages and Stages Questionnaire (ASQ) at 12 months of age. We conducted a randomized controlled trial investigating the effect of DCC (≥180 s) versus ECC (≤60 s) in 540 full-term deliveries. Twelve months after delivery, the parents reported their infant's development by ASQ. Infants having a score < 1 standard deviation (SD) under the mean score were considered "at risk" of affected neurodevelopment. At 12 months of age, 332 (61.5%) infants were assessed. Fewer children in the DCC group were "at risk" of having affected neurodevelopment measu...

Research paper thumbnail of Delayed cord clamping in Nepal-Evidence for implementation

Rana, N. 2019. Delayed cord clamping in Nepal-Evidence for implementation. Digital Comprehensive ... more Rana, N. 2019. Delayed cord clamping in Nepal-Evidence for implementation. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1557. 66 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-513-0611-7. The aims of this thesis were to investigate effects of timing of umbilical cord clamping on newborn health, and on infant outcomes up to 12 months of age in a high-risk population and to explore the context of implementing changed umbilical cord clamping practices in Nepal. A randomised controlled trial with 540 late preterm and term infants born by normal vaginal delivery was set up at a maternity hospital in Kathmandu, Nepal. Infants were enrolled in two parallel groups (1:1 ratio), randomised to early (ECC) (≤60 seconds) or delayed cord clamping (DCC) (≥180 seconds). To get a deeper understanding of barriers and enablers for change in clinical practise in relation to cord clamping, a qualitative study with delivery staff was set up. Focus group ...

Research paper thumbnail of Additional file 7 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 7 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 7. Key features of the EN-BIRTH data capture application.

Research paper thumbnail of Additional file 6 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 6 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 6. List of electronic tools reported by organisations with at least two responden... more Additional file 6. List of electronic tools reported by organisations with at least two respondents to the survey. Table shows number of stakeholder survey respondents per organisation (where at least 2 respondents from the same organisation responded) and the data collection, management and analysis tools used per organisation.

Research paper thumbnail of Additional file 4 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 4 of Electronic data collection, management and analysis tools used for outbreak response in low- and middle-income countries: a systematic review and stakeholder survey

Additional file 4. List of studies excluded from the systematic review (2010–2020) and their reas... more Additional file 4. List of studies excluded from the systematic review (2010–2020) and their reasons for exclusion. Dataset that describes the studies excluded from the systematic review (2010–2020) and includes the first author, title, journal and year of publication of the study and the reason for exclusion.

Research paper thumbnail of Every Newborn Birth Indicator Research Tracking in Hospitals (EN-BIRTH) - Supplementary Materials

Every Newborn Birth Indicator Research Tracking in Hospitals (EN-BIRTH) - Supplementary Materials

The EN-BIRTH study aims to validate selected newborn and maternal indicators for routine facility... more The EN-BIRTH study aims to validate selected newborn and maternal indicators for routine facility-based tracking of coverage and quality of care for use at district, national and global levels. This is an observational study of >22,000 facility births in three countries (Tanzania, Bangladesh and Nepal). Direct clinical observation are compared with facility register data and a pre-discharge maternal recall survey for indicators including: uterotonic administration, essential newborn care, neonatal resuscitation and Kangaroo Mother Care. Indicators for neonatal infection management and antenatal corticosteroid administration, will be validated using inpatient records because they cannot be easily observed. Trained clinical observers in labour/delivery ward, operation theatre, and Kangaroo Mother Care ward/areas collect data using a tablet-based customised data capturing application. Sensitivity will be calculated for numerators of all indicators and specificity for those numerator...

Research paper thumbnail of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

BMC Pregnancy and Childbirth, 2021

BackgroundObservation of care at birth is challenging with multiple, rapid and potentially concur... more BackgroundObservation of care at birth is challenging with multiple, rapid and potentially concurrent events occurring for mother, newborn and placenta. Design of electronic data (E-data) collection needs to account for these challenges. TheEvery NewbornBirth Indicators Research Tracking in Hospitals (EN-BIRTH) was an observational study to assess measurement of indicators for priority maternal and newborn interventions and took place in five hospitals in Bangladesh, Nepal and Tanzania (July 2017–July 2018). E-data tools were required to capture individually-linked, timed observation of care, data extraction from hospital register-records or case-notes, and exit-survey data from women.MethodsTo evaluate this process for EN-BIRTH, we employed a framework organised around five steps for E-data design, data collection and implementation. Using this framework, a mixed methods evaluation synthesised evidence from study documentation, standard operating procedures, stakeholder meetings an...

Research paper thumbnail of Additional file 5 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 5 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 5. Data flow assessment checklist by EN-BIRTH intervention.

Research paper thumbnail of Additional file 3 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 3 of Electronic data collection for multi-country, hospital-based, clinical observation of maternal and newborn care: EN-BIRTH study experiences

Additional file 3. Consolidated criteria for reporting qualitative research (COREQ) checklist.

Research paper thumbnail of Additional file 1: of Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) – a randomized clinical trial

Additional file 1: of Intact cord resuscitation versus early cord clamping in the treatment of depressed newborn infants during the first 10 minutes of birth (Nepcord III) – a randomized clinical trial

ANOVA analysis including post-hoc multiple comparisons comparing the infants divided into three g... more ANOVA analysis including post-hoc multiple comparisons comparing the infants divided into three groups, intact cord resuscitation per protocol (CC ≥ 180 s), intact cord resuscitation protocol violaton (CC