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Cycle 1

Principal Investigator:  Onesmus Gachuno, University of Nairobi
NIH-Supported Collaborator: James Kiarie, University of Nairobi
Title of NIH Award: Linked-Strengthening Maternal, Newborn and Child Health Research Training in Kenya

Project Overview
In Kenya, neonatal mortality accounts for 60% of infant mortality. One third of these deaths are due to intra-partum complications resulting in birth asphyxia which can be prevented by effective interventions. The Government of Kenya has identified inadequate provider competencies in Emergency Obstetric and Neonatal Care (EmONC) as a major challenge to implementation of quality Maternal and Newborn Health (MNH) services and has prioritized improving skilled care and enhancing the capacity of health facilities to provide these services.

In high-resource countries, simulation training has had the greatest success in changing practice and behavior in EmONC particularly in emergency situations however, the models used are expensive, complicated and not conducive for limited-resource settings. PRONTO developed a low-tech highly realistic simulation and team based training specifically for limited-resource settings which has been shown to improve health worker competencies in EmONC and decrease perinatal mortality. This training addresses skill and system barriers to the provision of sustainable quality EmONC thus reducing neonatal and maternal morbidity and mortality.

Using a cluster randomized trial design; we will test the hypothesis that PRONTO training will improve 24 hour neonatal mortality. Participating health facilities in Kisii County will be randomized into two arms: PRONTO training and standard of care. The study population is Kisii health facilities, the workers caring for women during labor and delivery at these health facilities, and their newborns.