A pilot study to promote child health in the first year of life

The fourth Millennium Development Goal is to reduce child mortality by two thirds by 2015. Progress in reducing child mortality has accelerated in many countries but the rates of child mortality are still high. Malawi has a child mortality of 112 deaths p er 1000 live-births. Since 2000 it has achieved a reduction of 23% in under-five deaths. The reduction is more evident between the second and the fifth year of life, being 28%. But in the neonatal period the reduction is half of the latter, being 14%. The high neonatal mortality rate is hindering Malawi in eradicating early loss of lives and reach MDG4. Being of low birth weight increases the risk of death four fold in the neonatal period. Maternal nutrition influences birth weight substantially. However, there is strong evidence that health and dietary counseling is effective in improving nutrition outcomes. Use of lay health workers in the delivery of preventive health care services shows cost-effectiveness. Thus we earlier (April 2012) proposed a rand omized controlled trial to test the effectiveness of improving birth weight by health and nutrition counseling delivered by lay health workers to mothers during pregnancy. In order to develop a robust methodology which would minimize as much as possible b oth known and unknown confounding, we now propose to undertake a seminar prior to the study implementation. The seminar will gather international and norwegian epidemiologists, biostatisticians and nutritionists as well as the Malawina policy makers who w ill review and develop the best possible and a state-of-the-art intervention as well as overall protocol for the cRCT. The seminar is deemed to foster the existing collaborations amongst the newly formed research group for the RCT project. It also aims a t extending the existing network milieu of collaborating partners for the faculty of medicine, University of Oslo, at large.