A pathway to scaling up chlorhexidine hand cleansing for prevention of neonatal infections in Bangladesh

Organization: 
The Research Foundation for the State University of New York
Organization Location: 
Buffalo, New York

Among the 2.8 million deaths each year in the neonatal period, 24% are attributable to infections.  Observational data suggests that maternal handwashing could prevent neonatal infections and death.  Handwashing promotion is a relatively weak component of neonatal care counseling, typically not addressing barriers to hand washing relevant to mothers of newborns in high neonatal mortality settings.  Barriers to handwashing include lack of access to handwashing materials, fear of excessive contact with water, and convenient cultural norms deterring mothers from requesting other household contacts to wash their hands. In our previous research in Bangladesh, a waterless chlorhexidine-based hand cleansing intervention increased hand cleansing 5-fold among mothers of newborns, and 10 to nearly 40-fold among other household contacts.   We propose to develop a pathway to scaling up chlorhexidine hand cleansing for neonatal care that includes improving the chlorhexidine product, refining the behavioral communication strategy, examining opportunities for integration into community perinatal care platforms, and evaluating the integrated promotion of the chlorhexidine hand cleansing intervention into a community-based perinatal care platform in rural Bangladesh.  At scale, the chlorhexidine hand cleansing intervention has the potential to reduce infections, improve the quality of newborn care, and save hundreds of thousands of newborn lives in high neonatal mortality settings worldwide.

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