Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study

Objective To assess the effect of the Safer Baby Bundle (SBB) of care in reducing perinatal mortality in Ethiopia.Design A quasi-experimental study design was implemented from February to August 2024. The intervention group received the five SBB care package adapted for Ethiopia; improving detection...

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Main Authors: Mesfin Tadese, Saba Desta Tessema, Solomon Hailemeskel, Alemayehu Moges, Michael Amera Tizazu, Getnet Mitike Kassie
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/9/1/e003502.full
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author Mesfin Tadese
Saba Desta Tessema
Solomon Hailemeskel
Alemayehu Moges
Michael Amera Tizazu
Getnet Mitike Kassie
author_facet Mesfin Tadese
Saba Desta Tessema
Solomon Hailemeskel
Alemayehu Moges
Michael Amera Tizazu
Getnet Mitike Kassie
author_sort Mesfin Tadese
collection DOAJ
description Objective To assess the effect of the Safer Baby Bundle (SBB) of care in reducing perinatal mortality in Ethiopia.Design A quasi-experimental study design was implemented from February to August 2024. The intervention group received the five SBB care package adapted for Ethiopia; improving detection and management of fetal growth restriction, raising awareness and improving care for women with decreased fetal movements, improving awareness of maternal safe going-to-sleep position, improving decision-making about timing of birth for women with risk factors for stillbirth and effective fetal monitoring during labour, and the control group received the standard care. Log-binomial regression analysis was performed to compare the outcome variables.Setting Four hospitals in North Shewa Zone, Ethiopia.Participants 841 women attending antenatal care were included.Outcome measures Stillbirth is the death of a baby before or during birth after 28 weeks of gestation in singleton pregnancies without lethal fetal congenital anomalies, whereas, early neonatal death is the death of a newborn occurring before hospital discharge.Results In this study, the overall stillbirth rate decreased by 24.8%, from 28.6 to 21.5 per 1000 live births, and neonatal mortality reduced by 19.9%, from 35.7 to 28.6 per 1000 live births, although these results were not statistically significant. Additionally, the intervention significantly reduced the incidence of non-reassuring fetal heart rate patterns during labour (adjusted risk ratio (aRR)=0.78, 95% CI 0.64 to 0.95), low birth weight (aRR=0.77, 95% CI 0.60 to 0.98) and the need for neonatal resuscitation (aRR=0.59, 95% CI 0.37 to 0.94). However, there was a concurrent increase in neonatal intensive care unit admissions (aRR=1.42, 95% CI 1.19 to 1.69).Conclusion The implementation of the SBB, adapted for Ethiopia, was associated with improvements in perinatal health outcomes. Further implementation research to identify causal effects and assess feasibility in Ethiopia and other low-income and middle-income countries is crucial.Trial registration number https://pactr.samrc.ac.za, PACTR202503889654904.
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spelling doaj-art-e723a0eca8a042e09e298e9fa2f94a122025-08-20T03:39:05ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722025-08-019110.1136/bmjpo-2025-003502Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental studyMesfin Tadese0Saba Desta Tessema1Solomon Hailemeskel2Alemayehu Moges3Michael Amera Tizazu4Getnet Mitike Kassie5Department of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Amhara, EthiopiaDepartment of Midwifery, School of Nursing and Midwifery, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Amhara, EthiopiaDepartment of Midwifery, Debre Berhan University, Debre Birhan, EthiopiaDepartment of Obstetrics and Gynecology, Debre Berhan University, Debre Birhan, EthiopiaDepartment of Public Health, Debre Berhan University, Debre Birhan, EthiopiaInternational Institute for Primary Health Care, Addis Ababa, EthiopiaObjective To assess the effect of the Safer Baby Bundle (SBB) of care in reducing perinatal mortality in Ethiopia.Design A quasi-experimental study design was implemented from February to August 2024. The intervention group received the five SBB care package adapted for Ethiopia; improving detection and management of fetal growth restriction, raising awareness and improving care for women with decreased fetal movements, improving awareness of maternal safe going-to-sleep position, improving decision-making about timing of birth for women with risk factors for stillbirth and effective fetal monitoring during labour, and the control group received the standard care. Log-binomial regression analysis was performed to compare the outcome variables.Setting Four hospitals in North Shewa Zone, Ethiopia.Participants 841 women attending antenatal care were included.Outcome measures Stillbirth is the death of a baby before or during birth after 28 weeks of gestation in singleton pregnancies without lethal fetal congenital anomalies, whereas, early neonatal death is the death of a newborn occurring before hospital discharge.Results In this study, the overall stillbirth rate decreased by 24.8%, from 28.6 to 21.5 per 1000 live births, and neonatal mortality reduced by 19.9%, from 35.7 to 28.6 per 1000 live births, although these results were not statistically significant. Additionally, the intervention significantly reduced the incidence of non-reassuring fetal heart rate patterns during labour (adjusted risk ratio (aRR)=0.78, 95% CI 0.64 to 0.95), low birth weight (aRR=0.77, 95% CI 0.60 to 0.98) and the need for neonatal resuscitation (aRR=0.59, 95% CI 0.37 to 0.94). However, there was a concurrent increase in neonatal intensive care unit admissions (aRR=1.42, 95% CI 1.19 to 1.69).Conclusion The implementation of the SBB, adapted for Ethiopia, was associated with improvements in perinatal health outcomes. Further implementation research to identify causal effects and assess feasibility in Ethiopia and other low-income and middle-income countries is crucial.Trial registration number https://pactr.samrc.ac.za, PACTR202503889654904.https://bmjpaedsopen.bmj.com/content/9/1/e003502.full
spellingShingle Mesfin Tadese
Saba Desta Tessema
Solomon Hailemeskel
Alemayehu Moges
Michael Amera Tizazu
Getnet Mitike Kassie
Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study
BMJ Paediatrics Open
title Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study
title_full Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study
title_fullStr Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study
title_full_unstemmed Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study
title_short Safer Baby Bundle intervention for reducing perinatal mortality in Ethiopia: a quasi-experimental study
title_sort safer baby bundle intervention for reducing perinatal mortality in ethiopia a quasi experimental study
url https://bmjpaedsopen.bmj.com/content/9/1/e003502.full
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