Maternal and Birth Attendant Hand Washing and Neonatal Mortality in Southern Nepal

Victor Rhee, MHS; Luke C. Mullany, PhD; Subarna K. Khatry, MBBS; Joanne Katz, ScD; Steven C. LeClerq, MPH; Gary L. Darmstadt, MD; James M. Tielsch, PhD

Arch Pediatr Adolesc Med. 2008;162(7):603-608.

Background More than 95% of neonatal deaths occur in developing countries, approximately 50% at home. Few data are available on the impact of hand-washing practices by birth attendants or caretakers on neonatal mortality.

Objective To evaluate the relationship between birth attendant and maternal hand-washing practices and neonatal mortality in rural Nepal .

Design Observational prospective cohort study. Setting Sarlahi District in rural southern Nepal .

Participants Newborn infants were originally enrolled in a community-based trial assessing the effect of skin and/or umbilical cord cleansing with chlorhexidine on neonatal mortality in southern Nepal. A total of 23 662 newborns were enrolled and observed through 28 days of life.