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Journal of Tropical Pediatrics 1994 40(1):24-28; doi:10.1093/tropej/40.1.24
© 1994 by Oxford University Press
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Avoiding Neonatal Death: An Intervention Study of Umbilical Cord Care

Paul Garner*,**,, Daina Lai*, Manasseh Baea*, Keith Edwards*** and Peter Heywood{dagger}

*Papua New Guinea Institute of Medical Research Madang, Papua New Guinea
**Department of Public Health and Policy, London School of Hygiene and Tropical Medicine London
***Child Survival Support Project, National Health Department Papua New Guinea
{dagger}Community Nutrition Programme, University of Queensland Medical School Brisbane, Australia

Correspondence: Paul Garner, Urban Health Programme, London School of Hygiene and Tropical Medicine, Keppel Street, London WCIE 7HT, UK

During a study of pregnancy in a poor rural tropical area, a high prevalence of neonatal fever and umbilical cord infection was detected. Interim analysis showed that this was associated with subsequent development of neonatal sepsis. Therefore an intervention was introduced in two stages. In the first stage, acriflavine spirit and new razor blades were supplied to mothers, along with instructions for use, through antenatal clinics. In the second stage, when excessive cord bleeding was reported, umbilical cord clamps were added to the pack. The packs were associated with reduction of serious morbidity in the neonatal period. The study demonstrates the importance of umbilical cord care in the aetiology of life threatening neonatal morbidity in village births in a developing country and the effect of a simple intervention in reducing morbid episodes in the neonate.


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