Saving newborn lives in Bangladesh and globally
The Lancet, one of the world's front line medical journals has shortlisted a Bangladeshi scientist's paper for its Papers of the Year 2008.
Profiles of an author from each of the shortlisted papers are published today in the Paper of the Year Shortlist section of the journal, and give a flavour of the personal and scientific events behind the research.
Abdullah Baqui, Associate Professor of the International Health department at Johns Hopkins Bloomberg School of Public Health, Baltimore, USA and founder President of Child Health Research Foundation in Bangladesh is the lead author of this shortlisted paper entitled 'Effect of community-based newborn-care intervention package implemented through two service-delivery strategies in Sylhet district, Bangladesh: a cluster-randomised controlled trial'.
The paper published in The Lancet in 2008; 371: 1936-44 outlines strategies that are simple but highly effective in reducing the neonatal mortality to a significant level.
The paper revealed that community-based approaches in management of potentially life-threatening neonatal infections can be safe and effectively provides the evidence needed to enable expansion of this avenue to reduce the 1 million annual deaths from these infections.
They have shown the successful outcomes of their simple intervention which involves training of one community worker per 4000 women, which is the usual ratio in Bangladesh for the health worker involved in family planning and health.
By this way they had effectively lessened the deaths of neonates by 34 percent. It has broken the old perceptions that high technology or high care hospital unit is needed for the survival of ill neonates and to cut the death toll which according to the author, some babies will need high technology but most of them do not.
Massee Bateman, director of the Saving Newborn Lives programme of Save the Children USA, expresses: "The important contribution of this study is to help us better understand how to make practical choices to take life-saving programmes to scale. As a result of the work, global and national policies and programmes will be informed and propelled to provide community-based approaches as a key strategy to improve newborn survival."
Dr Shams El-Arefin, Senior Scientist and Head of Child Health Programme of International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), who is one of the co-authors of the paper told Star Health, "The lessons from the study will help us reaching the goal of MDG-4."
Dr Arefin also added, "The encouraging achievement is the recognition of the study findings in different forums including the government sector. We are now working to adopt these findings in National Neonatal Health Strategy of Bangladesh in collaboration with the government."
Dr Samir Saha, Head of the department of Microbiology of Dhaka Shishu Hospital and Executive Director of Child Health Research Foundation said, "In countries like ours where care-seeking behaviour is poor and access to healthcare is difficult, this new package and algorithm can offer very cheap, feasible and effective service in reducing the child mortality." He thinks that the model could easily be replicated where the situation is alike. Dr Saha is also one of the co-authors of the study.
Baqui says that future work must find out how to scale up what we know: "There are a lot of good studies out there showing impact. But when we take them into larger programmes, we lose the effectiveness. We need research on how you take an intervention from half a million people to the millions of people living in poor communities of Asia and Africa without losing effectiveness."
To vote for this paper as The Lancet's 2008 Paper of the Year, visit http://www.thelancet.com.
About Paper of the Year of The Lancet
Introduced in 2003, the selection of the paper of the year is intended to draw attention to outstanding research and the teams whose cooperation and effort make such advances possible. Many of the papers are remarkable not only for their contribution to health care, but also for the manner in which diverse stakeholders combined expertise to address common important issues.
Readers are invited to vote online from December 19, 2008, to January 12, 2009, for The Lancet's paper of the year 2008. Six finalist papers (panel) were selected by the editors from 23 nominations made by members of the journal's International Advisory Board and from staff at The Lancet.
By contrast with previous years, the 2008 paper will not be chosen by the editors, but by The Lancet's readers. By encouraging readers to consider each piece of research and to select a winning paper, we hope to broaden discussion not only about these publications in particular, but also about what constitutes good research and promising directions of inquiry for the future.