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Table 2 Definition of primary outcomes

From: Can a community health worker administered postnatal checklist increase health-seeking behaviors and knowledge?: evidence from a randomized trial with a private maternity facility in Kiambu County, Kenya

Outcome measure Definition
Outcomes measured at 3 days postpartum
Maternal complication detected and referred CHWs documented any observed or reported maternal complications detected through administration of the checklist; data collected for study participants assigned to CHW treatment by phone or home visit
Newborn complication detected and referred CHWs documented any observed or reported complications detected through administration of the checklist; data collected for study participants assigned to CHW treatment by phone or home visit
Outcomes reported at 10 days postpartum
Maternal referral acted upon Binary variable indicating CHW referral was made (from programmatic data) and respondent reporting seeking facility-based care based on referral advice
Newborn referral made and acted upon Binary variable indicating CHW referral was made (from programmatic data) and respondent reporting seeking facility-based care based on referral advice
Facility-based maternal postpartum care sought Binary variable indicating whether respondent reported going to a health facility for her health since delivery
Days postpartum maternal care sought, among maternal care-seekers Continuous variable indicating days after delivery maternal care was sought, for those who report seeking facility-based maternal care
Facility-based newborn postpartum care sought Binary variable indicating whether respondent reported bringing her baby for a child wellness clinic visit
Days postpartum newborn care sought, among maternal care-seekers Continuous variable indicating days after delivery newborn wellness care was sought, for those who report seeking facility-based newborn wellness care
Any maternal health problem reported Binary variable indicating respondent reported yes to the question, “Are you having any problems with your health, related to your delivery, since you delivered?”
Maternal problem reported and action taken Binary variable indicating respondent reported yes to the question, “Did you do anything as a response to this problem?”, administered to respondents who reported a newborn health problem.
Any newborn health problem reported Binary variable indicating respondent reported yes to the question, “Is your baby having any problems with his/her health since you delivered?”
Newborn problem reported and action taken Binary variable indicating respondent reported yes to the question, “Did you do anything as a response to this problem?”, administered to respondents who reported a newborn health problem.
Number of maternal danger signs named Accurate identification of maternal danger signs defined as ability to name any of the following 11 predefined signs: fever/chills, foul-smelling vaginal discharge, convulsions/loss of consciousness, heavy vaginal bleeding (defined as soaking through a pad every hour), severe headaches, dizziness or faintness, visual disturbance (blurry vision or unusual difficulty seeing), increased cramping or abdominal pain, increased perineal pain, swelling, redness or discharge, difficulty passing urine, difficulty breathing, breast redness or hot to the touch, and pain or lump in the breast.
Can name 3 or more maternal danger signs Binary variable coded for continuous outcome variable, indicating whether 3 or more maternal dangers signs were named
Number of newborn danger signs named Accurate identification of infant danger signs defined as ability to name any of the following eight signs: fever, jaundice, poor feeding, lethargic/unresponsive, umbilical cord redness or discharge, convulsions, abnormal breathing (including panting, fast breathing, grunting, or nasal flaring, and pus from eyes.
Can name 3 or more newborn danger signs Binary variable coded for continuous outcome variable, indicating whether 3 or more newborn dangers signs were named
Can name 2 or more hand washing best practices Accurate identification of hand washing best practices defined as ability to name any of the following times that are particularly important for a caregiver to wash hands: after using the toilet, before touching/holding baby, after washing or touching nappies
Can name 2 or more cord care practices Accurate identification of sources of cord care practices defined as ability to name any of the following best practices to prevent cord infection: keep cord clean and dry, do not apply anything to stump, keep cord outside nappy/diaper
Can name 3 or more newborn thermal care practices Accurate identification of sources of dietary protein defined as ability to name any of the following best practices to ensure baby stays warm: keep room where newborn stays warm, dress newborn in several layers of clothes, bathe baby quickly in cold weather using warm water and dry and dress baby quickly, keep newborn’s head covered, practice skin to skin contact
Can name 3 or more sources of dietary protein Accurate identification of sources of dietary protein defined as ability to name any of the following: beans, lentils, meat, eggs, chicken, fish, milk
Applied water or nothing to umbilical stump Binary variable indicating nothing or water applied to umbilical stump. The checklist and data collection defined best practices in umbilical cord care according to Jacaranda Health’s clinical practice of dry cord care at the time of data collection. While Kenya introduced a change in its newborn care clinical guidelines from dry care to use of topical antiseptic in November 2013, the World Health Organization recommends both dry cord care and topical antiseptic as best practice [33, 34].
Appropriate newborn thermal care practiced Binary variable indicating respondent mentions trying to keep baby warm when asked how she bathes her baby
Exclusive breastfeeding Binary variable indicating only newborn consumed only breastmilk since birth
Breastfed 3 or more times in past 8 hours Binary variable indicating respondent reports feeding baby 3 or more times in 8 hours prior to the survey
Outcomes reported at 9 weeks postpartum
At least one dose of polio and pentavalent vaccines Binary variable indicating that respondent reports infant has received at one or more doses of polio vaccine and one or more doses of pentavalent vaccine when asked which vaccinations the infant has received since delivery
Use of family planning method Binary variable indicating respondent reports current use of any family planning method
Exclusive breastfeeding Binary variable indicating only newborn consumed only breastmilk since birth
Breastfed 3 or more times in past 8 hours Binary variable indicating respondent reports feeding baby 3 or more times in 8 hours prior to the survey
Index measures
Index of health knowledge at 10 days post-delivery Summative index with a maximum of 6 points and a minimum of 0 points, where each point represents knowledge of the following 6 postnatal health topics: 1) ability to name 3 or more maternal danger signs; 2) ability to name 3 or more infant danger signs; 3) ability to name 2 or more hand washing best practices; 4) ability to name 2 or more; 5) ability to name 3 or more recognized newborn thermal care practices; 6) and ability to name 3 or more sources of maternal dietary protein
Index of health practices at 10 days and 9 weeks post-delivery Summative index with a maximum of 8 points and a minimum of 0 points, where 4 points represent 4 key health practices reported at 10 day (exclusive breastfeeding, breastfed 3 or more times in the past 8 hours, appropriate newborn thermal care practices, and water or nothing applied to umbilical cord stump) and 4 points represent 4 key health practices reported at 9 weeks (exclusive breastfeeding, breastfed 3 or more times in the past 8 hours, use of postnatal contraception, infant has received at least one dose of polio and pentavalent vaccines).