Effect of behaviour change communication on qualified medical care-seeking for sick neonates among urban poor in Lucknow, northern India: a before and after intervention study

OBJECTIVE To assess the impact of a behaviour change communication (BCC) intervention on qualified medical care-seeking for sick newborns in urban Lucknow, northern India. METHODS Before and after intervention study conducted at two urban public hospitals at Lucknow. Neonates who did not have any morbidity or congenital malformation and were residents of Lucknow were enrolled within 48 h of birth and followed once between 6 and 8 weeks at the outpatients' clinic or home to assess the primary outcome measure which was qualified medical care-seeking for any neonatal illness. Mothers in the after-intervention phase received BCC intervention at enrolment, targeted at identification of danger signs of neonatal illnesses and promotion of qualified medical care-seeking. Analysis was by intention to treat. RESULTS In the before-intervention phase, 510 neonates were enrolled (from March 2007 to August 2007) and 481 (94.3%) were followed up. In the after-intervention phase, 510 neonates were enrolled (September 2007-April 2008) and 490 (96.1%) were followed up. Neonatal morbidity was 50.3% (242/481) and 44.3% (217/490) in before and after intervention phases, respectively. Qualified medical care-seeking for neonatal illnesses was significantly higher among mothers after-intervention (OR = 2.12; 95% CI = 1.42-3.16; P = 0.0001). CONCLUSION Since the behaviour change intervention package led to significant improvement in qualified medical care-seeking for sick newborns, this may be tested for effectiveness in other settings and considered for scaling up here, with rising proportion of institutional deliveries.